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This binding activates receptor autophosphorylation, which triggers a downstream signaling cascade through the phosphorylation of tyrosine residues of the insulin receptor substrates, IRS (IRS-1 or IRS-2), followed by phosphorylation of phosphatidylinositol 3-kinase (PI3K), phosphoinositide dependent kinase-1, Akt (Akt1 and Akt2), protein kinase C (PKC) and mammalian target of rapamycin (mTOR), as well as ribosomal protein S6 kinase beta 1 (S6K1) [10, 11]

(PubMed) Witte AV, Kerti L, Margulies DS, Floel A

serum is plasma with the clotting factors removed.) The more common plasma and serum tests measure extracellular (outside of cells) levels of nutrients, while RBC tests measure intracellular (inside of cells) levels of nutrients