Although PAMPs circulate at low concentrations under physiologic conditions (DiBaise et al, 2012), an increase in LPS concentrations, a condition termed “metabolic endotoxemia”, may provoke low‐grade inflammation (Cani et al, 2008), insulin resistance (Cani et al, 2007), augmented cardiovascular risk (Manco et al, 2010), fatty liver disease (Brun et al, 2007), white adipose tissue inflammation (Caesar et al, 2015), and retinopathy of prematurity (ROP) (Tremblay et al, 2013). Here, INS is linked to retinopathy of prematurity.