INS and Insulin resistance: Thirdly, another important chapter is the higher risk of cardio-metabolic traits underlying insulin resistance in adults with primary hyperparathyroidism; hence, anomalies of pancreas-related insulin secretion and its peripheral receptors’ dysregulation represent one more milestone in the issue of pancreas findings (of functional type in this particular instance, not of tumor type as seen in pancreatic NETs such as insulinomas) in the parathyroid field [14,15].