In this study, in 99 residents with HUA, diabetes did not develop suggesting HUA might not be the causative factor for diabetes, but IR/hyperinsulinemia could be the causative factor for HUA because in hyperinsulinemia more urate is reabsorbed in the proximal tubule via urate reabsorption transporters like the most crucial urate transporter, GLUT9 and also OAT10 (15). This evidence concerns the gene SLC22A13 and hyperinsulinism.