INS and Insulin resistance: With respect to the role of hyperinsulinaemia in influencing increased BMD, it has been shown that insulin resistance and excess insulin are common features in people with type 2 diabetes, and that insulin has an anabolic effect on bone due to its structural homology to Insulin-like Growth Factor-1 (IGF-1) by interacting with the IGF-1 receptor which is present on osteoblasts [12].