Macronutrient content of food is a key factor affecting gastric emptying andfoods with a high fat or protein load are known to delay gastric emptying bycausing the release of peptides such as glucagon like peptide-1 (GLP-1), gastricinhibitory polypeptide (GIP) and cholecystokinin (CCK).37 Resultant delayed hyperglycemia and insulin resistance38 leads to glucose patterns similar to those typically observed in peoplewith gastroparesis. The gene discussed is INS; the disease is gastroparesis.