For instance, hyperglycemia may amplify inflammatory responses via oxidative stress, advanced glycation end products (AGEs) and endothelial injury, while inflammatory cytokines impair insulin receptor substrate (IRS) phosphorylation and suppress glucose transporter 4 (GLUT4) activity, exacerbating hyperglycemia (40) and insulin resistance (41). This evidence concerns the gene IARS1 and Insulin resistance.