CPT2 and hyperinsulinemic hypoglycemia, familial, 4: The final clinical impact of the process described is related to the fact that elevated fat stores within the muscle cell play a role in the development of insulin resistance (Storlien et al., 1991; McGarry, 1992; Pan et al., 1997), with even more dramatic consequences on glucose and fats metabolism when a CHORD is combined with a lifestyle based on inactivity, as currently suggested in CPTII deficiency.