INS and Insulin resistance: The participants in cluster 2 who developed diabetes showed significant increases in insulin resistance (from 0.84 ± 0.20 to 1.18 ± 0.49, p < 0.001), along with a modest decrease in insulin secretion (from 72.9 ± 17.4 to 64.6 ± 18.8, p = 0.005) during the 5-year follow-up period.