This high incidence of VZ among patients with DM may be due to the significant reduction in key immune functions, such as cell-mediated immunity, phagocytosis, and opsonization.[35] Moreover, certain antidiabetic medications (such as thiazolidinediones, alpha-glucosidase inhibitors, dipeptidyl peptidase-4 [DPP-4] inhibitors, and insulin) have been associated with an increased risk of HZ, potentially due to their inhibitory effect on CD26, a key molecule involved in immune regulation.[36] We also found a notable proportion of those infected experienced complications (48.6%). Here, INS is linked to diabetes mellitus.