For local anesthesia, routine use of local anesthetic with 1:100 000 epinephrine is generally well tolerated for type II diabetic patient.37 Particular care should be taken in patients with type I diabetes treated with high doses of insulin, especially those with unstable blood glucose levels, and the use of vasoconstrictors should be minimized due to the potential for vasoconstrictor-enhanced hypoglycemia.38 The gene discussed is INS; the disease is Hypoglycemia.