In addition, viral hepatitis can affect insulin function and increase gluconeogenesis via upregulating the activity of the FOXY forkhead family of transcription factors 1 and 3 in the nucleus, increasing protein phosphatase 2A levels [60] or upregulating histone deacetylase 9 and deacetylation of forkhead box protein O1 (FOXO1) [61]. Here, INS is linked to viral hepatitis.