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. Here, INS is linked to type 1 diabetes mellitus.