We splitted the administration of basal insulin into two separate injections (insulin degludec, 0.34 IU/Kg/day, injected twice daily, with a time interval between the two injections of 12 h) and oral hypoglycemic agents (linagliptin 5 mg, pioglitazone 30 mg, metformin 1,700 mg, and gliclazide MR 120 mg) were administered to prevent diabetic ketoacidosis, as the patient had subsequent tolerable abdominal stiffness. This evidence concerns the gene INS and diabetic ketoacidosis.