Onepatient (with pre-existing diabetes) developed uncontrolled hyperglycemia after fourinjections and required additional insulin, finally reaching good metabolic control.Despite the very low rate of this complication, it is advisable to control bloodpressure and glycemia after PT injections in patients with pre-existing conditions.Adrenal insufficiency is another very rare adverse effect (0.8%) that may occur inpatients that require more than four injections. This evidence concerns the gene INS and diabetes mellitus.