After further adjustment for T2DM duration, BMI, SLM, FFM, SMM, FFMI, SMI, HbA1c, 2h PG, AKP, UA, TC, LDL-C, HGB, IGF-1, OC, CTX, PINP, 25 (OH)D, PTH, and use of insulin and its analogs, GLP-1 receptor agonists, SGLT-2 inhibitors, compared to the Q1 of CTI, subjects in Q3 and Q4 still had a remarkably increased risk of DR (OR 4.061, 11.086, separately). Here, INS is linked to type 2 diabetes mellitus.