We included 1235 moderate to severe DFI cases: 266 females (22%); 84% type II diabetes; 927 (75%) under insulin medication; 700 (57%) active smokers with a median of 35 pack-years (interquartile range (IQR), 20–60 p-y); 265 patients (21%) with heart and 624 persons (51%) with chronic renal insufficiency, of which 105 (9%) in renal dialysis; 29 (2%) with solid organ transplantations, 302 (24%) with high alcohol consumption, 76 (6%) under immune-suppressive therapy, among which 20 episodes under oncologic chemotherapy. This evidence concerns the gene INS and chronic kidney disease.