Cohort selection
death
The target population consisted of the Lombardy residents aged ≥ 65 years who were NHS beneficiaries. Of these, those who received ≥ 3 consecutive prescriptions of oral antidiabetic agents during 2012 were identified and the date of the third prescription was defined as the index date. We considered that three consecutive prescriptions within a year are indicative of regular prescription and use. Because insulin might require frequent changes in dose requirements over time, patients prescribed only insulin were not included in the study. Two additional categories of patients were excluded from the analysis, i.e., those who had not been NHS beneficiaries for at least 5 years before the index date and those who did not reach at least 6 months of follow-up. The remaining patients were included into the final cohort whose members accumulated person-years of follow-up from the index date until the earliest date among death, emigration or June 30