However, hypertonicity in these patients is more a reflection of the degree of hyperglycemia and not due to osmotic diuresis, as previously discussed.13 It has been proposed that adequate insulin administration alone, with limited or without intravenous fluid resuscitation, may resolve the metabolic disturbances without complications.13 Current guidelines recommend an insulin infusion with a glucose correction rate of 50–75 mg/dL/hour. This evidence concerns the gene INS and Hyperglycemia.