https://www.selleckchem.com/products/Rapamycin.html Trends of severe hypoglycemia were associated with changes in drug classes rather than number of antidiabetic drugs. Relentless efforts to reduce the prescription of drugs with a high risk of hypoglycemia should be implemented, particularly for older women with multiple comorbidities. Trends of severe hypoglycemia were associated with changes in drug classes rather than number of antidiabetic drugs. Relentless efforts to reduce the prescription of drugs with a high risk of hypoglycemia should be implemented, particularly for older women with multiple comorbidities. To assess the effects of glycated haemoglobin (HbA ) levels at time of glucose-lowering treatment intensification in DISCOVER, a global observational study of patients with type 2 diabetes (T2D) initiating second-line therapy. Outcomes of interest were glycaemic control, hypoglycaemia, and need for further intensification during 3years of follow-up. We included patients who intensified treatment (add-on or insulin initiation) upon initiation of second-line therapy (baseline). Outcomes were assessed according to baseline HbA HbA ≤7·5% (early intensification) or HbA >7·5% (late intensification). Factors associated with early or late intensification were assessed using multivariate logistic regression. Of the 9575 patients included, 3275 (34·2%) intensified treatment early and 6300 (65·8%) intensified treatment late. During follow-up, mean (SD) HbA was lower in the early- than in the late-intensification group (6·9% [0·95%] vs 7·5% [1·28%] at 36months). More patients had HbA <7·0% in the early- than in the late-intensification group (61·8% vs 37·9% at 36months; p<0·001). The risk of further intensification was higher in the late-intensification group (hazard ratio 1·88 [95% confidence interval 1·68-2·09]). Occurrence of hypoglycaemia was similar in both groups. Late intensification of glucose-lowering therapy after first-line treatment failure reduces the l