While glucotoxicity may influence HOMA2-B values, particularly in the SIDD cluster (mean HbA1c 10.4%), the identification of insulin-deficient subtypes across the glycemic spectrum, including among individuals with prediabetes, supports the presence of primary beta-cell defect in South Asians rather than secondary suppression alone.36 Thus, clustering provides added explanatory value by capturing pathophysiologic patterns that are obscured when examining individual variables in isolation. The gene discussed is INS; the disease is prediabetes syndrome.