INS and Insulin resistance: Ectopic lipid accumulation promotes the development of insulin resistance through the formation of toxic lipid intermediates such as ceramides and diacylglycerol, which interfere directly and indirectly with insulin signaling and insulin-regulated metabolic pathways [19], as well as through altered secretion of insulin-sensitizing lipid signaling molecules (e.g., fatty acid esters) [20, 21].