In the multivariable Cox proportional hazard regression model adjusted for sex, age, marital status, duration of diabetes, hemoglobin A1c, estimated glomerular filtration rate, cardiovascular disease, use of insulin, use of cholesterol lowering medicine, and use of blood pressure lowering medicine, exposure to once-weekly semaglutide also was independently associated with a higher risk of upcoming NAION (HR 2·19, 95% CI 1·54 − 3·12). Here, INS is linked to cardiovascular disorder.