Factors include uremia reducing gluconeogenesis, renal dysfunction weakening insulin clearance, dialysis causing malnutrition, increased red blood cell glucose uptake, rapid plasma glucose removal by dialyzer, abnormal secretion of anti-regulatory hormones, improved insulin sensitivity after dialysis, and exogenous insulin application leading to mostly asymptomatic and dangerous hypoglycemia 6-10. The gene discussed is INS; the disease is nutritional deficiency disease.