Crude rates of all-cause mortality, MACE, and cancer were highest in people treated with insulin monotherapy: 61.3 versus 21.2 deaths per 1,000 person-years (p<0.001), 26.3 versus 15.9 MACE per 1,000 person-years (p<0.001), and 24.6 versus 18.7 cancer events per 1,000 person-years (p<0.001) for patients treated with insulin monotherapy versus insulin plus metformin, respectively (Table 3). This evidence concerns the gene INS and cancer.