INS and diabetes mellitus: Among the participants with a family history of type 2 diabetes, 66.66% had ≥ grade 1 AN in this study, which is higher than that previously reported in the San Antonio Family Diabetes Study [28], which found that 41.1% of participants with a family history of type 2 diabetes had ≥ grade 1 AN, which correlated with fasting insulin and BMI.