Increasing age, male sex, Malay ethnic group, longer duration of diabetes, overweight, obesity, hypertension, diabetic retinopathy, diabetic foot ulcer, nontraumatic lower-extremity amputation, ischaemic heart disease, stroke, insulin, higher numbers of antihypertensive agents, antiplatelet agents, poorer HbA1c control, higher systolic BP, non-achievement of triglyceride target, and non-attainment of HDL-cholesterol goal are independent factors associated with DKD. This evidence concerns the gene INS and diabetes mellitus.