Consistent with previous data our results show elevated des-31,32 proinsulin to insulin ratios in people with T2DM [11], but this was not observed in the fasting state or at early time points after an OGTT in our group of non-diabetic post-gastrectomy patients who hyper-secrete insulin as a consequence of increased GLP-1 levels arising from the altered surgical anatomy [34]. Here, INS is linked to type 2 diabetes mellitus.