```xml
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<ns3:query_definition xmlns:ns2="http://www.i2b2.org/xsd/cell/crc/psm/1.1/" xmlns:ns4="http://www.i2b2.org/xsd/cell/crc/psm/analysisdefinition/1.1/" xmlns:ns3="http://www.i2b2.org/xsd/cell/crc/psm/querydefinition/1.1/">
    <query_name>outpatient-1000000045@10:26:36</query_name>
    <query_timing>ANY</query_timing>
    <specificity_scale>0</specificity_scale>
    <panel>
        <panel_number>1</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>4</hlevel>
            <item_name>Primary hypertension NOS</item_name>
            <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Circulatory system (390-459)\Hypertensive disease (401-405)\(401) Essential hypertension\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Circulatory system \ Hypertensive disease \ Essential hypertension</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>2</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>2</hlevel>
            <item_name>Diabetes mellitus (e08-e13)</item_name>
            <item_key>\\ICD10_ICD9\Diagnoses\(E00-E89) Endo~c157\(E08-E13) Diab~1uxc\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Endocrine, nutritional and metabolic diseases (e00-e89) \ Diabetes mellitus (e08-e13)</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>3</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>1</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>4</hlevel>
            <item_name>Insulin</item_name>
            <item_key>\\i2b2_MEDS\i2b2\Medications\MUL\(LME148) hormones\(LME150) antidiabetic agents\(LME152) insulin\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>medications \ hormones \ antidiabetic agents \ insulin</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
</ns3:query_definition>

```

I want to find patients with a diagnosis of primary hypertension (NOS) in the circulatory system, as well as those with diabetes mellitus (e08-e13) as an endocrine, nutritional, or metabolic disease, but exclude those who have been prescribed insulin as an antidiabetic agent. The query should be accurate and specific, considering any timing and including all occurrences of the mentioned conditions.