Finally, the most consistent risk factor for time to insulin was isoleucine level, which was nominally significant in the discovery cohort (HR = 1.09, 95% CI = 0.96–1.25), a risk factor for incident diabetes in MDC (HR = 1.48, 95% CI = 1.26–1.74) and DESIR (OR = 23.88, 95% CI = 3.13–182.31) as well as prevalent diabetes (OR = 10.94, 95% CI = 3.94,30.32). Here, INS is linked to diabetes mellitus.