The European-T2D PRS and metformin PRS were associated with progression to insulin use (HR: 1.07 [95% CI 1.02–1.12] per SD, P = 0.004; 1.06 [95% CI 1.01–1.11] per SD, P = 0.013, respectively) (S10 Table). Here, INS is linked to type 2 diabetes mellitus.