INS

Chr 11ADAR

insulin

Also known as: IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10, PNDM4

Insulin is a peptide hormone that decreases blood glucose concentration and increases cellular uptake of glucose, amino acids, and fatty acids. Mutations cause multiple forms of diabetes including permanent neonatal diabetes, maturity-onset diabetes of the young type 10, insulin-dependent diabetes, and hyperproinsulinemia, with both autosomal dominant and autosomal recessive inheritance patterns. The gene has intermediate constraint against loss-of-function variants and is covered in GeneReviews for additional clinical guidance.

Summary from RefSeq, OMIM, UniProt
Research Assistant →

Primary Disease Associations & Inheritance

Diabetes mellitus, insulin-dependent, 2MIM #125852
AD
Diabetes mellitus, permanent neonatal 4MIM #618858
ADAR
HyperproinsulinemiaMIM #616214
AD
Maturity-onset diabetes of the young, type 10MIM #613370
AD
UniProtType 1 diabetes mellitus 2
12
Active trials
1115
Pubs (1 yr)
105
P/LP submissions
39%
P/LP missense
1.17
LOEUF
Multiple*
Mechanism· predicted
Clinical SummaryINS
🧬
Gene-Disease Validity (ClinGen)
monogenic diabetes · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

2 total gene-disease associations curated

Population Constraint (gnomAD)
Constrained for loss-of-function variants (OE-LoF 0.25) despite low pLI — interpret in context.
📋
ClinVar Variants
61 unique Pathogenic / Likely Pathogenic· 75 VUS of 225 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — INS
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
1.17LOEUF
pLI 0.301
Z-score 1.39
OE 0.25 (0.091.17)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
0.90Z-score
OE missense 0.68 (0.540.88)
44 obs / 64.3 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.25 (0.091.17)
00.351.4
Missense OE0.68 (0.540.88)
00.61.4
Synonymous OE1.12
01.21.6
LoF obs/exp: 1 / 4.0Missense obs/exp: 44 / 64.3Syn Z: -0.51
DN
0.85top 5%
GOF
0.84top 5%
LOF
0.3550th %ile

This gene has evidence for multiple mechanisms of pathogenicity (dominant-negative and gain-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to dominant-negative as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

DNprediction above median · 1 literature citation
GOFprediction above median · 1 literature citation

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Literature Evidence

DNGiven the frequent tendency of heterozygous INS mutations to exhibit dominant negative disease pathogenesis, it is likely that the mutant preproinsulin perturbed the non-mutant counterpart progression and processing within the β-cells, and this resulted to a permanent form of congenital diabetes.PMID:23350652
GOFHeterozygous, gain-of-function mutations of the insulin gene can cause permanent diabetes with onset ranging from the neonatal period through adulthood.PMID:18840770

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

225 submitted variants in ClinVar

Classification Summary

Pathogenic37
Likely Pathogenic24
VUS75
Likely Benign38
Benign16
Conflicting29
37
Pathogenic
24
Likely Pathogenic
75
VUS
38
Likely Benign
16
Benign
29
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
5
32
0
37
Likely Pathogenic
1
19
4
0
24
VUS
2
38
35
0
75
Likely Benign
0
0
22
16
38
Benign
0
0
16
0
16
Conflicting
29
Total36210916219

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

INS · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Obesity

Effect of Tirzepatide on Brown Adipose Tissue in Obesity

ACTIVE NOT RECRUITING
NCT06893211Phase PHASE2University Medical Centre LjubljanaStarted 2025-03-18
TirzepatidePlacebo
Prostate Cancer

Training for Men Undergoing Androgen Deprivation Therapy.

RECRUITING
NCT06449664Phase NAThe Swedish School of Sport and Health SciencesStarted 2024-05-01
ADT-train
ObesityInsulin Resistance

Complex Effects of Dietary Manipulation on Metabolic Function, Inflammation and Health

ACTIVE NOT RECRUITING
NCT02706262Phase NAWashington University School of MedicineStarted 2016-02
Metabolically abnormal obese - Mediterranean dietMetabolically abnormal obese - Low carbohydrate ketogenic dietMetabolically abnormal obese - Plant-based, very-low-fat diet
Diabetes MellitusGut Microbiota

Correlation Between Gut Microbiota and Pancreatic Β-Cell Function in Diabetic Patients

ENROLLING BY INVITATION
NCT06645223Peking University Third HospitalStarted 2024-09-20
No Interventions
Impaired Glucose RegulationImpaired Glucose Tolerance (Prediabetes)Prediabetes (Insulin Resistance, Impaired Glucose Tolerance)

Probiotic Impact on Cognitive Performance, and Metabolic Outcomes in Overweight Young Adults With Impaired Glucose Regulation

RECRUITING
NCT07073781Phase NALeeds Beckett UniversityStarted 2025-08-15
Lab4p Probiotic ConsortiumPlacebo
MASLD - Metabolic Dysfunction-Associated Steatotic Liver DiseaseCirrhosisAdvanced Fibrosis

MASLD in Type 2 Diabetes in Primary Care - a Follow-up Study

ENROLLING BY INVITATION
NCT07312136Linkoeping UniversityStarted 2025-12-16
Menstrual CycleAthletesPhysical Activity

Identifying Periods of High Training Load Considering the Menstrual Cycle Phases in Elite and Non-elite Female Athletes

RECRUITING
NCT06377306Wingate InstituteStarted 2023-11-05
Effect of training loads and sport performance level on health and sport performance
ObesityHealthy Volunteers

Physical and Behavioral Traits of Overweight and Obese Adults

RECRUITING
NCT00428987National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Started 2007-03-08
Obesity and Obesity-related Medical ConditionsCardiovascular RiskGenetics

Cardiometabolic Risk of Obese Subjects: Cross-sectional Study

RECRUITING
NCT06714058IRCCS Azienda Ospedaliero-Universitaria di BolognaStarted 2024-11-30
ObesityGlucose IntoleranceDiabetes

A Biological Atlas of Severe Obesity (Biological Tissue Collection)

RECRUITING
NCT01129297University Hospital, LilleStarted 2006-06-13
Telomere LengthBreast Cancer Females

Avocado Consumption and Cellular Aging in Breast Cancer Survivors

RECRUITING
NCT07097155Phase NAInstitut Investigacio Sanitaria Pere VirgiliStarted 2026-01-12
Daily Avocado Consumption
Diabetes Mellitus

Role of High-Throughput Whole Genome Sequencing for the Diagnosis and Care of Atypical Diabetes

RECRUITING
NCT06570278Phase NAInstitut National de la Santé Et de la Recherche Médicale, FranceStarted 2024-10-30
WGS coupled with MCM
Clinical Literature
Open Research Assistant →
Full-Text Mentions
NLP-detected gene mentions in article bodies · via PubTator3
PubTator3
Kinderrechte ins Grundgesetz!!
Geschäftsstelle der DGKJP·Z Kinder Jugendpsychiatr Psychother
2023
Aufbruch ins Pharmatasialand
Grebe I·CME (Berl)
2023
Bienenstich ins Auge.
Heyer C·MMW Fortschr Med
2024
The ins and outs of microvesicles
Clancy JW et al.·FASEB Bioadv
2021
Bienenstich ins Auge!
Holzgreve H·MMW Fortschr Med
2021
Top 5 full-text resultsSearch PubTator3 ↗