Heinzerling et al. [39] proposed a diagnostic flowchart, suggesting manifestations related to the acute presentation (urticaria, rash, angioedema, dyspnea, nausea, diarrhea, and cardiovascular manifestations) are likely to be IgE-mediated and suggest the need for skin prick testing and assessment of IgE-insulin-specific titers. The gene discussed is INS; the disease is urticaria.