Patients Who Have Type 2 Diabetes No Longer Express Genes

Patients who have type 2 diabetes no longer express genes when exposed to insulin.How might this phenomenon be explained?

A) The nucleus of their cells are altered so that insulin can not bind.
B) The insulin signal transduction pathway becomes permanently activated.
C) Transcription factors normally activated by insulin remain off.
D) Insulin can no longer bind to the insulin receptor because the receptor is mutateD.
E) The signal transduction pathways in the cells no longer exist.