highly significantp = 0.001
Insulin had a highly significant negative correlation with DPR ( p = 0.001, r = −0.303) while having an extremely significant positive correlation with ALSFRS-R total score ( p < 0.001, r = 0.394), as well as with ALSFRS-R subscores like Respiratory ( p < 0.001, r = 0.411), Bulbar ( p = 0.001, r = 0.307), and Fine Motor ( p < 0.001, r = 0.341).