Using WHO STEPS standard methodology [27], diabetes was defined as “fasting plasma glucose levels ≥ 7.0 mmol/L, and/or currently taking insulin or oral hypoglycemic drugs,”[27] hypertension (BP) was defined as “systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg or currently on antihypertensive medication” (mean of the last two of three readings), raised total cholesterol (TC) (“fasting TC ≥ 5.0 mmol/L or currently on medication for raised cholesterol”), and general overweight/obesity (measured Body Mass Index:”25–29.9 kg/m2 overweight and ≥ 30 kg/m2 obesity”) [28]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.