These findings dovetail with those from adult studies showing that metabolite profiles predictive of T2D are detectable up to a decade prior to the development of T2D precursors such as elevated fasting insulin and insulin resistance [5,7], and growing literature on children and adolescents showing prospective associations of metabolites with metabolic disease precursors and biomarkers [13,14,16]. This evidence concerns the gene INS and Other metabolic disease.