GPT and Insulin resistance: In addition, improvement of AST/ALT levels and no changes in BMI suggests that the effect of denosumab on insulin resistance might be caused by improvement of hepatic insulin resistance, similar to the results documented in the in vivo study by Kiechl and colleagues.[10] Accordingly, our study might reveal the effect of denosumab upon the glycemic and metabolic parameters of patients with T2DM, including its mechanism of action.