INS and Insulin resistance: In particular in the type 2 scenario, this ER stress can induce a process lasting many years or even decades, comprising both an initial phase of compensatory hyperinsulinemia due to insulin resistance and a subsequent phase of a slowly developing hypoinsulinemia due to deterioration of the insulin biosynthetic capacity in the beta cell ER and the gradual decease of the beta cell volume (Lenzen 2017).