The lack of dyslipidaemia or fatty liver in severe insulin resistance due to INSR or PIK3R1 defects [68, 69] raises the possibility that these subtypes of insulin-resistant diabetes might confer lower macrovascular risk than type 2 diabetes, mandating a different, ‘precision’ approach to primary prevention; however, this has not been tested longitudinally (Fig. 2a). The gene discussed is INSR; the disease is Insulin resistance.