INS and Patent ductus arteriosus: PDA risk in short-term insulin use (less than 3 years) is significantly increased, while people who started insulin more than 5 years showed a relatively lower risk (0.5–0.7 folds) than new starters (Li et al., 2009; Colmers et al., 2012; Singh et al., 2013; But et al., 2017).