On Cox proportional hazards regression analysis, age (HR 0.973, p = 0.044), diabetes duration (HR 0.807, p < 0.001), insulin (HR 1.692, p = 0.059), sodium-glucose co-transporter-2 inhibitor (HR 1.752, p = 0.072), hemoglobin (HR 1.242, p = 0.020), triglyceride (HR 1.004, p = 0.006), mean HbA1c (HR 1.898, p < 0.001), HbA1c ARV (HR 6.206, p < 0.001), HbA1c CV (HR 1.130, p < 0.001) were associated with DR development with p < 0.1. Here, INS is linked to diabetes mellitus.