1.INS ≥22.7, TNF-α ≥3.9, AGEs ≥11.6, and Cr ≥1.1 are important predictive factors for distinguishing DM-DD from DM-N.2.Combined markers (TNF-α + INS + AGEs + Cr) exhibit an AUC of 0.913 and a specificity of 100%. Here, INS is linked to diabetes mellitus.