12-year-old MN DSH with a history uncontrolled diabetes mellitus was presented for evaluation of ravenous appetite, shaking, and restlessness. Current therapy was 9 IU PZI SQ BID. Urinalysis showed SG of 1.024 and glycosuria. CBC was within reference range. Abnormalities on serum biochemistry were hyperglycemia, elevated ALT and ALP activity, and hypokalemia. T4 was within reference range.