The global diabetes epidemic does not affect primitive tribes and people continuing to live traditionally in regions of the world with a high number of centenarians and elderly people without disease or chronic health problems.37 All people with type 2 diabetes have insulin resistance, which renders insulin testing redundant in patients with severe obesity.38 Several biological and hormonal factors have been linked to the increasing global prevalence of metabolic syndrome.39 Here, INS is linked to diabetes mellitus.