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High post-load insulin levels were found to predict the development of IGT as well as DM in the Pima Indians (left panel). Similar data were obtained in the Island of Nauru (right panel) where the inhabitants also have high prevalence of diabetes. Individuals with higher fasting insulin levels have higher incidence both of diabetes itself and of IGT. Therefore higher fasting or post-load insulin levels precede both IGT and Type 2 diabetes.