INS and heart failure: At 3-years, compared to the insulin/SU group, the metformin/pioglitazone/SGLT2i/GLP-1 RA group had a lower risk of heart failure (HR 0.34, 95% CI 0.13-0.87, <i>p</i> = 0.018), acute coronary syndrome (HR 0.29, 95% CI 0.12-0.67, <i>p</i> = 0.002), stroke (HR 0.17, 95% CI 0.06-0.49, <i>p</i> < 0.001), chronic kidney disease (HR 0.50, 95% CI 0.25-0.99, <i>p</i> = 0.042), and hospitalisation (HR 0.59, 95% CI 0.46-0.77, <i>p</i> < 0.001).