Cardiovascular events and insulin therapy: a retrospective cohort analysis.

To investigate the impact of insulin plus other risk factors on cardiovascular disease (CVD) events in patients with type 2 diabetes (T2D), we conducted a retrospective study among patients with T2D from a U.S. managed care plan (n=342,692). Date of first CVD event was defined as index date. For patients without events, index date was date of last-observed claim. CVD event rates were calculated; odds of CVD event were compared for patients with/without insulin use. Events analyzed included stroke, MI, other cardiac/cerebrovascular events. Among insulin group (n=14,167), 22 patients/1000 patient-years experienced a CVD event, compared with 19/1000 patient-years in non-insulin group (n=328,077). Adjusting for risk factors and comorbidities, odds of event for insulin group compared to non-insulin group was 0.66, ranging from 25% lower for patients aged 65+ to 42% lower for patients aged 31-45. Insulin treatment of T2D was associated with reduced risk of CVD events compared to other or no therapy.