INS and Hyperglycemia: The development and perpetuation of hyperglycemia occur concomitantly with hyperglucagonemia; the resistance of peripheral tissues to the action of insulin; increased hepatic insulin resistance, incretin dysfunction, increased lipolysis, and a consequent increase in free circulating fatty acids; increased renal reabsorption of glucose; and varying degrees of deficiency in the synthesis and insulin secretion by the pancreatic β cell.