Patient B, with long-standing T2DM, lost ≈11 % of body weight, normalised HbA1c from 9.5 % to 6.1 %, and reduced basal insulin by ≈70 %, aligning with outcomes observed in tirzepatide-treated patients in SURPASS-5, where mean HbA1c reductions ranged from 1.2 to 2.3 % and mean weight loss 5–9 % at 40 weeks [3]. The gene discussed is INS; the disease is type 2 diabetes mellitus.