To determine the significant predictors for LLA, we considered the following factors to be clinically important: age of the patient ≥50 years, obesity, hypertension, duration of T2DM over 20 years, insulin therapy, statin intake, LDL level, nephropathy, retinopathy, PAD and Wagner's classification (grade ≤3 vs grade ≥4). Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.