Also, patients with diabetic foot ulcers fared poorly in HRQoL scores than those without, in a study from Sudan [12]. Type 2 diabetes mellitus patients had lower HRQoL owing to old age of 64 years, longer duration of the disease, poor glycemic control, obesity, insulin use, and other diabetes-related complications [13]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.