Skeletal muscle biopsies: splicing dysregulation toward IR-A in patients. No relation between IR-A/IR-B expression ratio and HOMA-IR in patients. Altered insulin signaling pathways in patients vs. controls in terms of protein level and phosphorylation status, dependent upon which muscle was evaluated. Myotubes: Changes in insulin signaling pathways in DM1 vs. controls after insulin stimulation, despite similar IR-A/IR-B expression ratios across groups. Here, INS is linked to myotonic dystrophy type 1.