INS and Hyperglycemia: Diabetes mellitus (DM) is characterized by hyperglycemia with insulin resistance in peripheral tissues or dysfunctional insulin secretion by pancreatic cells.240 Studies have found that DM tends to cause skeletal health disorders, which include a high risk of fracture, delayed bone healing, and diabetes-associated bone mineral loss.241,242 Compelling evidence suggests that hyperglycemia diverts BMSCs to a metabolically stressed adipogenic pathway instead of osteogenic responses through monocyte-adhesive hyaluronan matrix synthesis.