However, in this mentioned study [41], after insulin discontinuation the level of blood glucose rise till mean 9.9 ± 2.1 mmol/l in diabetic patients without heart failure, while in our group of asymptomatic diabetic patients hyperglycemia was significantly higher and we analyzed not only global strain (like in Nielsen study) [41], but all three LV myocardial layers which could explain different results. Here, INS is linked to Hyperglycemia.