The observed pattern of changes in metabolic parameters by neighbourhood socioeconomic disadvantage is consistent with the multistage causes of type 2 diabetes.19, 20 In the early stages of diabetes, a long period of insulin resistance is accompanied by a compensatory increased rate of insulin secretion.17, 21 We saw related increases in insulin concentrations and a substantial reduction in HOMA insulin sensitivity when participants were in their early twenties. Here, INS is linked to type 2 diabetes mellitus.