INS and diabetes mellitus: Compared to individuals without diabetes, there was a doubling in risk of the primary composite outcome in patients on insulin [fully adjusted HR 2.19; 95% confidence interval (CI) 1.94–2.48; P < 0.001], whereas patients with diabetes not treated with insulin had a 50% higher risk (HR 1.49; 95% CI 1.34–1.66; P < 0.001).