Elevated free fatty acids (FFAs) in the IR state lead to increased ceramide and diacylglycerol(DAG), inhibiting glucose transporter-4 (GLUT-4) membrane translocation in skeletal muscle and adipose tissue, interfering with glucose uptake, and forming a vicious cycle of hyperglycemia and hyperinsulinemia [46]. This evidence concerns the gene SLC2A4 and Hyperinsulinemia.