INS and type 2 diabetes mellitus: This encompasses a number of immune metabolic aspects, including the key role of the tricarboxylic cycle or sphingosine-1-phosphate in the regulation of vascular inflammation.59, 60 Clinical studies have shown that patients with T2D have increased total leukocyte counts, particularly neutrophils and lymphocytes, that correlate with insulin sensitivity,61 which is in part mediated by inflammatory changes of adipose tissue.62