The elevated risks were attenuated, but remained significantly higher, in the other patients with diabetes not receiving insulin, with a fully adjusted HR of 1.46 (95% CI 1.14–1.86; P = 0.003) for sudden death and 1.83 (95% CI 1.36–2.46; P < 0.001) for pump failure death, respectively. This evidence concerns the gene INS and diabetes mellitus.