INS and diabetic retinopathy: In a subgroup analysis to evaluate complications in individuals with T2D (n = 208,268), we observed that the preserved insulin secretion cluster was associated with lower odds of diabetic neuropathy (OR, 0.70, P < 10−5) diabetic retinopathy (OR 0.86 P < 10−18), and insulin use (OR 0.93, P < 10−7) (Fig. 3, Supplementary Table 8).