INS and diabetes mellitus: Contrarywise, it should be avoided in patients of extreme ages (<18 or >75 years old), uncompliant with ketone protocol or with deficits in diabetes self-management, recurrent DKA and other ketosis events, ketogenic or very low caloric diet, BMI ≤ 18.5 kg/m2, total dose of insulin received < 0.3 U/kg/day, and recurrent serious infections or acute illness (osteomyelitis, cellulitis, urosepsis, foot ulcers).