Compensatory hyperinsulinemia activates the Mitogen-Activated Protein Kinase/Extracellular signal-Regulated Kinase (MAPK/ERK) pathway (63), increasing the secretion of inflammatory markers such as Intercellular Adhesion Molecule-1 (ICAM-1), Vascular Cell Adhesion Molecule-1 (VCAM-1), and PAI-1 (64). Here, VCAM1 is linked to hyperinsulinism.