INS and Stroke: We found that in diabetic patients with acute stroke, older age was independently associated with higher insulin use (adjusted OR per decade: 1.8, 95% CI: 1.3–2.5; p = 0.001), while no significant associations were observed with gender, stroke type/location, atrial fibrillation, thrombolysis, or functional outcomes (NIHSS/MRS scores at discharge/3 months; all p > 0.05).