The worse glycemic control and the greater proportion of insulin-treated individuals in this and other studies [5–7, 9–12, 29, 30] suggest a more severe insulin deficiency, consistent with the more rapid decline in β-cell function reported in early- versus late-onset type 2 diabetes [3, 13], though evidence is mainly derived from studies in individuals diagnosed in childhood or adolescence [31]. Here, INS is linked to type 2 diabetes mellitus.