In addition, people suffering from DM not only have increased production of ketones, their ketone clearance is also decreased significantly, because of low insulin levels, and decreased activities of succinyl-coenzyme-A: 3 oxoacid coenzyme-A-transferase and β-hydroxybutyrate dehydrogenase, which all contribute to an increased level of ketones (34). This evidence concerns the gene INS and diabetes mellitus.