TNF and type 2 diabetes mellitus: Furthermore, in a previous study, the levels of C18:0, C20:0, C24:1, and total ceramides were found to be elevated in type 2 diabetic subjects compared to controls and were inversely correlated with insulin sensitivity, concluding that these species may contribute to insulin resistance through the activation of inflammatory mediators, such as TNF‐alpha (Haus et al., 2009).