INS and obesity due to melanocortin 4 receptor deficiency: Vellanki et al (2016) [38], in a trial of sitagliptin vs metformin and placebo in pre-selected African-American individuals with overweight or obesity in Atlanta USA with new or hyperglycaemia and unprovoked ketosis or DKA and who had insulin discontinued within 12 weeks of initial presentation, reported a 2 year overall insulin independence rate of 58%.