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These approaches included anti-IGF-1R monoclonal antibodies (mAbs), IGF-1R tyrosine kinase inhibitors (TKIs), IGF-1/2 blocking mAbs, IGF ligand-TRAPs, recombinant IGFBPs and pregnancy-associated plasma protein-A (PAPP-A) inhibition [54,55]

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Specifically, the generation of ceramides by dihydroceramide desaturase 1 (DES1) in adipocytes seems to impart some of the lipotoxic effects such as impaired glucose utilization, insulin resistance and hepatic steatosis (198)

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