INS and diabetes mellitus: These findings contrasted with previous studies, which reported that insulin pump use was associated with a lower likelihood of DR in the pediatric and pregnant populations.14,15 Other studies in adults with T1D observed a lower incidence and progression of DR and other microvascular complications (specifically albuminuria) in those who started insulin pump therapy and had a shorter diabetes duration.12,13 The median duration of diabetes in our cohort was longer, at 20 years, than those reported in other studies, potentially accounting for the conflicting data.14,15