A systematic review analyzing risk factors for adverse outcomes in adults and children with hyperglycemia presenting to the emergency department found that age (< 25 years and > 65 years), lower socio-economic status, use of insulin, complicated diabetes (micro-vascular and macro-vascular complications), recurrent emergency department visits/ hospitalizations, poor .drug adherence, and sepsis were associated with worse outcomes for both DKA and Hyperosmolar Hyperglycemic state (HHS). Here, INS is linked to diabetes mellitus.