For DM patients, insulin resistance has been associated with detrimental biological processes such as impaired vascular production of nitric oxide and increased levels of endothelin-I and angiotensin-II.[47] Insulin has both proatherogenic and antiatherogenic properties, which would differentially modify the risk of cardiovascular events, depending on the presence of insulin resistance and hyperinsulinemia.[48]. Here, INS is linked to hyperinsulinism.