INS and metabolic syndrome: The results indicated better insulin sensitivity assessed by HOMA-IR, glycemic control measured via HbA1c, reduced cardiovascular risk through the TG/HDLc ratio and improved depressive symptoms with increased self-efficacy monitored by Patient Health Questionnaire 9 (PHQ-9) and General Self-Efficacy Questionnaire (GSE) / Metabolic Syndrome Compliance Questionnaire (MSC) [39].