INS and diabetes mellitus: In bivariate logistic regression analysis, rural residence (OR 1.940), presence of any diabetic complication (OR 3.125), insulin use (OR 2.687), and presence of major depression (OR 4.753) were associated with greater odds of DD, whereas higher age (≥40 years) at diabetes diagnosis (OR 0.403) and longer duration (> 10 years) of diabetes (OR 0.240) were associated with lower odds of DD (Table 2).