Reasons for exclusion were myocardial infarction in the previous year, current angina or heart failure, accelerated hypertension, proliferative or pre-proliferative retinopathy, renal failure with a plasma creatinine concentration >175 μmol/l, other life-threatening disease such as cancer, an illness requiring systemic steroids, an occupation which precluded insulin treatment, language difficulties, or ketonuria >3 mmol/l suggestive of insulin dependent diabetes mellitus [18,28]. Here, INS is linked to angina pectoris.