INS and diabetes mellitus: In the entire analytic cohort (N = 855,133), in a multivariable Cox regression model adjusted for demographics, duration of diabetes, comorbidities, blood pressures, BMI, HbA1C, diabetes medications and use of ACE-I/ ARB, insulin use (HR 2.44, 95% CI 2.36 to 2.53) and more advanced CKD (HR 2.43, 95% CI 2.27 to 2.59 for comparison of eGFR < 30 versus ≥90 ml/min/1.73 m2 group) were both associated with increased risk of serious hypoglycemic events (Fig. 4, panel A).