However, the patient’s significant diurnal fluctuations: the largest amplitude of glycemic excursions (LAGE) was 28.7 mmol/L and the standard deviation of blood glucose (SDBG) was 8.44 mmol/L, characterized by persistent daytime hyperglycemia and spontaneous nocturnal hypoglycemia, as well as the lack of response to several insulin regimens (intravenous insulin, insulin pump, and insulin degludec/liraglutide), were inconsistent with the typical insulin resistance associated with renal disease. This evidence concerns the gene INS and Hyperglycemia.