INS and type 2 diabetes mellitus: 1998). The increase in the fasting proinsulin:insulin ratio occurs in pancreatic beta‐cell dysfunction (Roder et al. 1998; Pfutzner and Forst 2011), and is associated with insulin resistance, type 2 diabetes (Pfutzner et al. 2004; Loopstra‐Masters et al. 2011), and an increased risk of first stroke (Lindahl et al. 2000) or first acute myocardial infarction (Lindahl et al. 1999) (see also [Zethelius et al. 2002]).