A 50 years-old male known type-2 diabetes patient for nearly 10 years who has been on metformin 850mg oral twice a day and self-adjusted doses of insulin. He presented with two months history of easy fatigability, malaise, and weight loss of 8kg over two months. But had no fever, no sweating. The patient had no other additional medical problem. The patient has no other medical illness. On physical examination; the vital signs are all within normal range. There was no lymph node enlargement, no hepatomegaly or splenomegaly, and no skin rash.