The major findings of the current study are as follows: 1) insomnia risk was significantly increased in the DR group, and a higher risk was noted in the PDR group; 2) males and the youngest age group with DR were more vulnerable to insomnia; 3) there was an interactive effect of DR status and DM duration on increasing insomnia risk; and 4) there was an interactive effect of PDR status and DM duration, insulin therapy status, and CKD status on increasing insomnia risk. This evidence concerns the gene INS and insomnia.