In case of HHS without acidosis (blood pH > 7.3, bicarbonate > 18 mmol/L) but with mild or moderate ketonemia (blood β-hydroxybutyrate ≥1.0 to <3.0 mmol/L or urine ketones <2+), insulin is initiated only after blood glucose stops decreasing, i.e., posthypovolemia correction. This evidence concerns the gene INS and hypotrichosis 1.