There’s also a connection between insulin resistance and micronutrient and EFA deficiencies, or there wouldn’t be detectable effects from chromium, biotin, magnesium and other nutrients required for insulin signalling. The old concept of the empty calorie has a lot to recommend it. Metabolic flexibility implies flexibility, and therefore some redundancy, in signalling, but micronutrient shortage is going to introduce economy instead?
http://ajcn.nutrition.org/content/45/5/877.full.pdf
Toxins, including popular pharmacueticals and heavy metals, are also implicated in IR, I seem to remember.
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