INSR and metabolic disease: Metabolic disorders including hyperglycaemia, dyslipidaemia, hypertension and central obesity often constellate as ‘metabolic syndrome'.1, 2 Insulin resistance and compensatory hyperinsulinaemia underline these metabolic imbalances.3 Hepatic insulin resistance may stem from compromised signalling through the insulin receptor, insulin receptor substrate (IRS) and other downstream effectors such as the Akt kinase.