However, compared with nonusers, insulin users had a significantly higher risk of hospitalization for COPD (aHR 1.7, 95% CI 1.24–2.32), bacterial pneumonia (aHR 2.42, 95% CI 1.95–3), NIPPV (aHR 5.05, 95% CI 2.76–9.22), IMV (aHR 2.72, 95% CI 1.99–3.72), and severe hypoglycemia (aHR 4.71, 95% CI 2.5–8.89). This evidence concerns the gene INS and Hypoglycemia.