INS and Insulin resistance: Ceramide, is suggested to play a significant role in inducing β-cell apoptosis, as well as in mediating insulin resistance and reducing insulin gene expression (14); sphingosine-1-phosphate, has been shown to improve β-cell function, promote glucose-stimulated insulin release, and protect against β-cell apoptosis (15); and sphingomyelin, which will be described more in details below has been connected to insulin resistance in animal studies (16, 17).