INS and heart failure: In the “Consensus on Insulin Treatment in T2DM” published by the Consensus and Clinical Guidelines Working Group of the Spanish Society of Diabetes (SED), it is recommended to continue treatment with metformin, dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), GLP-1 RAs, and/or sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) and consider stopping or reducing sulfonylurea/meglitinide treatment to decrease the risk of hypoglycemia and pioglitazone due to the increased risk of heart failure associated with this combination (5).