INS and Insulin resistance: Two studies from Korea (Lee et al., 2016) and Japan (Someya et al., 2021) found that insulin resistance evaluated by HOMA-IR and estimating clamp-derived insulin sensitivity from the oral glucose insulin sensitivity index was an independent risk factor of vascular damage, such as cortical atherothrombotic embolism and lacunar stroke, which is positively correlated with the incidence and severity of vascular damage.