Although the elevated monocyte level was significantly associated with an increased prevalence of DKD after adjusting for age, sex and duration of diabetes (P for tend < 0.001), no association was found between the monocyte level and DKD after adjusting for age, sex, education status, duration of diabetes, current smoking, BMI, HbA1c, dyslipidemia, systolic blood pressure and insulin therapy. This evidence concerns the gene INS and diabetic kidney disease.