But other diabetes clinical risk factors that were significantly associated in varying degree with depression in people with diabetes includes hypertension and microvascular complication [37], diabetic nephropathy [17], physical activities, glucose testing [22], presence of co-morbidities, longer duration of treatment, treatment with insulin [10] and elevated fasting blood sugar level, physical disability and lack of a physician’s advice about lifestyle modifications [32]. Here, INS is linked to major depressive disorder.