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One important factor is the use of concomitant medications such as insulin, sulfonylureas, or pioglitazone which can promote weight gain and blunt weight loss, Dr Ambrish Mithal, Chairman, Endocrinology and Diabetes, Max HealthCare, and a co-author of the study, told ThePrint

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It is becoming increasingly clear that, by looking at single cells types separately or isolated islets, deprived of the natural microcirculation, one misses important paracrine effects that each hormone and cell type exert on its surrounding cells, because all substances reach the peripheral cells by uncontrolled diffusion

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in turn resulting in MPS augmentation and as a consequence muscle maintenance and growth (Sandri et al., 2013