There are caveats in our study: on average, one of four critically ill patients with no history of diabetes has stress hyperglycemia (the tentative implicated mechanisms include the release of counter-regulatory hormones, the alteration of insulin receptor signaling caused by inflammation and the inhibition of pancreatic beta-cell function and of endogenous insulin secretion) [8,17]. The gene discussed is INSR; the disease is Hyperglycemia.