These finding are consistent with the positive relationship between severe hypoglycaemia and increased mortality reported in the ACCORD [9], ADVANCE [10], and VADT [11] and with the observation that, in the ACCORD, risk of death was higher in the intensive than in the conventional group only in patients requiring more aggressive treatment, including insulin, because of little or no decrease in HbA1c following treatment initiation [12]. Here, INS is linked to Hypoglycemia.