Although the reason for the inverse association between urate level and glycemic status is unknown, there is a possibility of involvement of insulin in changes in serum urate level in patients with diabetes: Insulin enhances renal tubular reabsorption of urate [18, 19], and thus in patients with diabetes, insulin deficiency increases urinary excretion of urate, resulting in a decrease in blood urate level. This evidence concerns the gene INS and diabetes mellitus.