In contrast, the Co-culture+PA group exhibited a sustained increase in insulin secretion (1 h: 22.3 ± 0.9 μg/L; 12 h: 26.6 ± 0.4 μg/L; 24 h: 27.1 ± 0.5 μg/L), indicative of persistent β-cell activation and a potential state of hyperinsulinemia. Here, INS is linked to hyperinsulinism.