INS and metabolic disease: Diabetes mellitus (DM) is a group of metabolic diseases characterised by hyperglycemia resulting from defects in insulin secretion, insulin action or both.1 High systolic blood pressure (BP), high body mass index (BMI), high fasting blood glucose, ambient particulate matter pollution and smoking are the five leading risk factors of stroke.2 Diabetes mellitus causes vascular endothelial dysfunction, increased early-age arterial stiffness, and systemic inflammation along with an increased risk of encountering other risk factors for stroke.3