In the international, open-label, observational A1chieve study in more than 66,000 individuals with T2DM initiated on insulin across 28 countries from 4 continents (Asia, Africa, Europe and South America), the overall prevalence of micro and macrovascular complications was 53.5% and 27.2%, respectively compared with 65.8% and 28.7% for micro and macrovascular complications in the Middle East subgroup (30). This evidence concerns the gene INS and type 2 diabetes mellitus.