Since arecoline has a hypoglycemic effect [30] and betel nut chewing has been associated with higher risk of diabetes [1], the relevance of the effects of arecoline on serum insulin levels of experimentally induced diabetic rats and its consequences on the male steroid pathway and sex accessories was analyzed with the presumption that a sizeable proportion of the 600 million betel nut chewers may also be diabetic. Here, INS is linked to diabetes mellitus.