Taken together, these results indicate that (1) cross talk occurs among the major kinase pathways, (2) inhibition of one kinase pathway may disinhibit another, and (3) hyperinsulinemia in conjunction with insulin resistance's canonical perturbed pathway (PI3K) exacerbates TNFα-stimulated increases in VCAM-1. This evidence concerns the gene VCAM1 and hyperinsulinism.