Relative to the low and stable class, these five showed increased risks of T2D complications, including stroke (HR=1.55 (1.31–1.84)), kidney disease (HR=1.39 (1.27–1.53)), all-cause mortality (HR=1.36 (1.23–1.51)), and progression to combination therapy (HR=3.22 (3.04–3.41)) or insulin (HR=3.21 (2.89–3.55)). Here, INS is linked to type 2 diabetes mellitus.