Additionally, the pathophysiology of vascular health is complex and influenced by a host of factors.2 Endothelial cells in separate vascular beds have differing structural and metabolic components, which could influence how they are affected by hyperglycaemia.39 It is possible that PAT is not as susceptible to variations in glycaemia as FMD and carotid-femoral PWV or that small elevations in glucose and insulin do not affect vascular health to the clinically evident degree that substantial (i.e. diabetes-level) elevations do. Here, INS is linked to Hyperglycemia.