Accordingly, older age was identified as a risk factor for DKD progression, independent of diabetes duration, in patients with T2DM [38]; a prospective observational cohort study of patients with T2DM followed for 10-years reported that albuminuria, older age, hypertension, insulin therapy, and lower baseline eGFR were independent predictors of annual eGFR decline [39]; and poor glycemic control and elevated BMI have been associated with the development and progression of DKD [40]. This evidence concerns the gene INS and diabetic kidney disease.