HSPA5 and Hyperglycemia: Equally important, the ability of R. delemar spores to invade and damage nasal epithelial cells was directly proportional to the expression of GRP78 on nasal epithelial cells triggered by host conditions mimicking hyperglycemia and ketoacidosis, thus explaining the increased susceptibility of diabetics in ketoacidosis to the rhino-orbito-cerebral form of mucormycosis (ROCM) (22).