A thin (BMI 24) 63-year-old white female who had had type 1 diabetes (GAD positive, C-peptide 0.4 ng/mL (normal range above 1 ng/mL)) since the age of 40 had poorly controlled diabetes (HbA1c 9.6%) due to her resistance to utilizing adequate doses of preprandial short-acting insulin due to her fear of hypoglycemia which in the past had been induced with short-acting insulin. The gene discussed is GAD1; the disease is type 1 diabetes mellitus.