INS and type 1 diabetes mellitus: Vascular dysfunction, a potentially reversible finding, develops much earlier than symptomatic cardiac disease; studies have demonstrated an increased carotid intima media thickness (cIMT, marker of early atherosclerosis) in children with T1D versus healthy peers, with an inverse association of estimated insulin sensitivity (IS) and cardiometabolic disease risk in adolescents with T1D (11–13).