When additional confounding factors such as hypertension, dyslipidemia, smoking, drinking, regular exercise status, BMI, FBS, insulin status, number of anti-diabetic medications, and DM duration were controlled for, the PDR group demonstrated the highest risk of insomnia incidence (aHR=1.205, 95% CI: 1.156-1.256). This evidence concerns the gene INS and hypertensive disorder.