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The relatively high systemic insulin levels counteract the lipolytic effects of the high GH levels in fat and muscle, but they do not reach adequate levels in the portal vein, so the liver remains under the control of GH, which still induces gluconeogenesis, increasing hyperglycemia [33]

Citation on PubMed or Free article on PubMed Central Das SK, Ray K

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One final convergence point of these related signaling events, is the initiation of the p38 MAPK and MAPK/ERK1/2 signaling pathways, that causes changes in gene expression and can modify cell metabolism and proliferation (106, 124)