INS and chronic obstructive pulmonary disease: To mitigate this bias, we have taken steps to consider factors such as age, sex, medication (Sulphonylurea, Thiazolidinediones, AGI, Insulin, DPP4 inhibitors and Meglitinides), treatments (Radiation therapy and Chemotherapy), and comorbidities (hypertension, hyperlipidemia, chronic obstructive pulmonary disease, chronic kidney disease, and heart failure).