INS and Insulin resistance: Elevated proinsulin levels (>10 pmpl/L) signify insulin resistance, as demonstrated by the IRIS-II study [41], with 80% of renal transplant recipients in the pancreatic β-cell dysfunction risk for NODAT study surpassing this threshold, suggesting a compromised β-cell function due to metabolic demands and prolonged exposure to immunosuppressive medications, thereby heightening NODAT risk for transplant recipients [33].