Age, BMI ≤ 32.5 kg/m2, duration of diabetes and hypertension ≥13 years and ≥18 years, respectively, daily insulin dose ≥ 0.585 IU/kg, eGFR ≤ 65.5 mL/min/1.73 m2, log L-citrulline ≥ 2.1, and the presence of diabetic retinopathy, CKD, CAD, PAD, and myocardial infarction in medical history were associated with CAS. Here, INS is linked to peripheral arterial disease.