INS and Hyperglycemia: Although insulin therapy is described as the final option in the recent algorithm of the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) for the treatment of diabetes, early introduction of insulin is recommended if there is evidence of ongoing catabolism (weight loss), if symptoms of hyperglycemia are present, or if glycated hemoglobin (HbA1c) (> 10%, 86 mmol/mol) or blood glucose levels (> 300 mg/dL) are very high4.