He has a complex medical history including pneumoconiosis secondary to silica exposure, multinodular nontoxic thyroid goiter with tracheal deviation, chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus (T2DM) with peripheral neuropathy and long-term use of insulin, hypertension, hyperlipidemia, insomnia, transient ischemic attack (TIA), and recurrent hospitalizations in the last year for pneumonia. The gene discussed is INS; the disease is transient ischemic attack.