Median follow-up across the 3 cohorts was 0.37 (IQR 0.20 to 0.76) years
The majority of patients were also using oral diabetic medications
ED visits or hospitalizations for hypoglycemia | Overall: 7347 events
Glargine: 5194 events
Detemir: 1693 events
NPH insulin: 460 events
Initiation of glargine and detemir use was associated with a reduced risk of hypoglycemia compared with NPH insulin
Glargine vs NPH insulin: HR 0.71 (95% CI, 0.63 to 0.80)
Detemir vs NPH insulin: HR 0.72 (95% CI, 0.63 to 0.82)
The protective association of long-acting insulin analogs varied by age and was not seen with concomitant prandial insulin use
In type 2 diabetes patients 65 years or older in Medicare, initiation of long-acting analogs was associated with a lower risk of ED visits or hospitalizations for hypoglycemia vs NPH insulin
This association was not seen with concomitant prandial insulin use
The authors state
The inclusion of prandial insulin in type 2 diabetes treatment regimens may increase complexity, especially for older users, thereby increasing the possibility of using too much insulin, which might increase the likelihood of hypoglycemia to such an extent that the benefits from long-acting analogs compared with NPH insulin are lost
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