Mentias A, et al. - Researchers evaluated how the risk of stroke and myocardial infarction (MI) in atrial fibrillation (AF) patients with diabetes is influenced by the use of insulin. For this purpose, they identified Medicare beneficiaries with new AF from 2011 to 2013. Overall 798,592 AF patients were included in this study, with 53,212 (6.7%) being insulin-requiring diabetics, 250,214 (31.3%) being non-insulin requiring diabetics and 495,166 (62%) non-diabetics. With regard to ischemic stroke and MI risk, an incremental risk was evident from non-diabetics to non-insulin diabetics with the highest risk in insulin users. With insulin use, a reduction in the protective impact of anticoagulation was also evident in this study.