The use of a high-protein diabetes-specific EN formula in hyperglycemic critically ill patients on mechanical ventilation leads to lower insulin requirements, reduces plasma and capillary blood glucose levels and glycemic variability, and could also reduce the risks of ICU-acquired ventilator-associated pneumonia and tracheobronchitis when compared with that of a standard high-protein formula. The gene discussed is INS; the disease is ventilator-associated pneumonia.