INS and Insulin resistance: The athlete paradox provides insights into the relationship between intramyocellular lipid and insulin resistance, highlighting that the detrimental effect of lipids on insulin sensitivity is dependent on the accumulation of reactive lipid species such as diacylglycerols and ceramides rather than accumulation of lipids in the form of triglycerides per se (Dresner et al., 1999; Yu et al., 2002; Samuel and Shulman, 2012; Kitessa and Abeywardena, 2016).