INS and hyperinsulinism: Alternatively, insulin may have a modulating effect on autonomic tone,12 although induced hyperinsulinemia, stimulated by glucagon-like peptide-1 has been shown not to decrease vagal control.28 A recent review mentioned that inflammation activated by cytokines (such as IL-6), including adipocytokines in adipose tissue, potentially influenced the autonomic nervous system,17 leading to the conclusion that abdominal obesity may impair autonomic function.