Assessing in vivo insulin secretion is complex because it is influenced by multiple factors including systemic insulin sensitivity, hepatic insulin extraction, plasma-free fatty acids, and glucolipid toxicity.(5) Insulin resistance is determined via HOMA-IR using the formula FPG × fasting insulin level/405, and the Japan Diabetes Society(2) defines a normal level as <1.6 and insulin resistance as >2.5. The gene discussed is INS; the disease is Insulin resistance.