In addition, the impact of hypoglycemia on 3P-MACE was substantially greater (HR: 2.29; 95% CI: 1.04–5.06) than that of the reference group (those without T2DM or hypoglycemia) after adjusting for age, sex, body mass index, diabetes duration (≥ 10 years), history of CVD, HF, etiology of HF, presence of CKD, SBP, fasting plasma glucose, HbA1c, use of insulin, sulfonylurea, antihypertensive medication, statin, levels of high-sensitivity troponin T, NT-proBNP, and C-reactive protein. The gene discussed is INS; the disease is diabetes mellitus.