It must be noted that pancreatic β-cells lack the levels of lactate dehydrogenase found in other cells such as muscle cells or pancreatic α-cells and as such do not operate glycolytically to generate ATP, which means that CI inhibition may lead to decreases in ATP-linked insulin secretion, potentially explaining the decrease in insulin secretion found in patients with long-term diabetes [132]. Here, INS is linked to diabetes mellitus.