This study revealed that ketosis‐prone T2DM was common (20.2%) in newly diagnosed T2DM, characterized by younger age, poorer islet function, severe hyperglycemia and dyslipidemia, higher levels of FFAs, HbA1c, urinary protein, longer duration of intensive insulin therapy and time for FPG to reach target, and lower proportion of macrovascular disease. The gene discussed is INS; the disease is metabolic syndrome.