What is the potential association between insulin use and increased mortality in diabetic patients with established HF?
Observational studies have demonstrated an association between insulin use and increased mortality in diabetic patients with established HF, although these findings are potentially limited by unmeasured confounding factors. Not all observational studies have demonstrated this increased hazard, and it is possible that insulin use may be a marker of more advanced disease and a high-risk group rather than a direct contributor to increased HF events and increased mortality in patients with HF.