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Evidence suggests that, in people with type 2 diabetes, risk for severe hypoglycemia does not necessarily differ between those who use long-acting insulin analogues and those who use neutral protamine Hagedorn (NPH) insulin (NEJM JW Gen Med Aug 15 2018 and JAMA 2018; 320:53). However, little is known about this risk in older people (age, ≥65). In this retrospective cohort study, researchers determined risk for emergency department (ED) visits or hospitalizations for hypoglycemia among 575,000 Medicare beneficiaries (mean age, 75) with type 2 diabetes who initiated long-acting insulin analogs (407,000 initiated glargine, and 142,000 initiated detemir) or NPH (26,000).
During average follow-up of less than 1 year, 7350 ED visits or hospitaliza…