In a multivariate logistic regression model that was adjusted for potential confounders, such as age, sex, race, marital status, family poverty index, education, insulin use, hypertension, and waist circumference, the BAR remained significantly associated with the risk of overall cardiovascular disease in diabetes (OR: 1.09; 95% CI: 1.06-1.12; P<0.001). Here, INS is linked to cardiovascular disorder.