Insulin therapy (with or without additional agents) should be introduced in patients with newly identified T2DM and frankly symptomatic (catabolic features like weight loss, ketosis or features of hyperglycemia including polyuria/polydipsia) and/or severely elevated blood glucose levels [≥300–350 mg/dL (16.7–19.4 mmol/L)] or A1C [≥10–12%] (11). The gene discussed is INS; the disease is Hyperglycemia.