INS and type 2 diabetes mellitus: Indeed, the pathways identified have all been implicated in aging and calcification.49 For example, medial arterial calcification is a common complication in type 2 diabetes and insulin signaling has been implicated directly in the maintenance of VSMC phenotype and protection from vascular calcification.50–53 Likewise, autophagy and lipid metabolism impact vascular calcification via multiple mechanisms.49,54