Prx4 may protect against the metabolic abnormalities leading to type 2 diabetes so that upregulated intracellular Prx4 synthesis and augmented extracellular Prx4 levels suppress oxidative stress and ameliorate local (e.g. hepatic or islet cells) and systemic inflammatory signalling and insulin sensitivity [9, 38]. This evidence concerns the gene INS and type 2 diabetes mellitus.