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Its the result of a tangled web of dysfunction involving: Insulin resistance: cells stop responding to insulin, leaving glucose in the bloodstream Excess glucagon: the liver keeps pumping out sugar, even when its not needed Low-grade inflammation: which damages tissues and disrupts metabolic signaling Impaired appetite regulation: driven by hormone imbalances and gut-brain miscommunication GLP-1 (glucagon-like peptide-1) helps untangle this web