INS and diabetes mellitus: Although this is considered an adaptive response, likely to be a mechanism to ensure the cells remain resilient to future periods of energy deprivation, this proves ‘maladaptive’ in diabetes, largely because of the inability to switch off exogenous insulin that is being released continuously from a subcutaneous depot, but also because of a hypoglycaemia-specific defect in alpha cell-derived glucagon release that is present in all people with type 1 diabetes after a few years of diagnosis and in some people with long-duration type 2 diabetes [9].