We did not observe any increased risks in stroke, cardiovascular death, microvascular complications of diabetes, or faster progression to insulin-based therapies.<h4>Conclusion</h4>Our retrospective data from two large cohorts suggest that the risk of MACE may be increased among patients with type 2 diabetes taking 5α-reductase inhibitors, potentially driven by increased risk of MI. This evidence concerns the gene INS and diabetes mellitus.