It is conceivable that the control of hyperglycemia obtained in the current experience should have been better achieved and maintained by treating the underlying specific causes of pasireotide-induced hyperglycemia, and applying the subsequently established recommendations, therefore, limiting insulin therapy to a selected number of cases with persistent uncontrolled hyperglycemia, despite treatment with metformin, DPP-4 inhibitor, and GLP-1 receptor agonist. The gene discussed is DPP4; the disease is Hyperglycemia.