INS and metabolic syndrome: While the pathophysiology of T2DM consists of multiple overlying factors, including insulin resistance, excess hepatic glucose release and defects in adequate insulin production [17,18], the potential utility for MetS to identify risk in adolescents for future T2DM was demonstrated in that adolescents with MetS (compared to those without MetS) have an odds ratio (OR) of 10 for developing T2DM by age 32 [19].