No other definitive guidelines exist for the management of severe HTG, but multiple treatment modalities have been described using apheresis, insulin, and heparin.16 If a patient has concomitant hyperglycemia, intravenous insulin can be considered.16 If not, then apheresis can be considered if well-tolerated.17 The primary aim is to prevent pancreatitis from becoming necrotizing and prevent organ failure. The gene discussed is INS; the disease is pancreatitis.