Experimental studies in rats reported that the lipoic acid synthetase (Lias) deficiency induces manifested DN with production of microalbuminuria, thickening of the basal glomerular membrane, proliferation of the mesangial matrix, and hypertension compared to the diabetic controls without Lias deficiency [71]. Here, LIAS is linked to hyperinsulinemic hypoglycemia, familial, 4.