In the older‐onset group not taking insulin, progression to PDR increased significantly in participants with advancing levels of severity from 31/31 (microaneurysms and one or more of the following: venous loops 31 μm or greater; questionable soft exudate, intraretinal microvascular abnormalities (IRMA) or venous beading; and retinal haemorrhages) onwards (WESDR: Klein 1989a). Here, INS is linked to Retinal hemorrhage.