INS and obesity due to melanocortin 4 receptor deficiency: Despite the increased evidence of insulin resistance in young patients with T1DM leading to overlap of clinical phenotype between the two types of DM, this event is not intrinsic to pathophysiology; rather, it is secondary to obesity, inflammation, exogenous insulin treatment in parallel with decreased insulin delivery to portal circulation, and, to certain degree, determined by genetics and ethnicity [42].