During the formation of 2–KBA, 2-hydroxybutyrate (2–HBA) is formed as a by-product, and mounting evidence has demonstrated that circulating 2-HBA is inversely correlated with insulin sensitivity and elevated 2-HBA is an early marker for both insulin resistance and impaired glucose regulation independent of sex, age, and BMI (Gall et al., 2010; Syed Ikmal et al., 2013). The gene discussed is INS; the disease is Insulin resistance.