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Hemoglobin glycation index (HGI) is the difference between observed and predicted glycated hemoglobin A1c (HbA ), derived from mean or fasting plasma glucose (FPG). In this secondary, exploratory analysis of data from DEVOTE, we examined whether insulin initiation/titration affected the HGI; the relationship between baseline HGI tertile and cardiovascular and hypoglycemia risk; and the relative strengths of HGI and HbA in predicting these risks. In DEVOTE, a randomized, double-blind, cardiovascular outcomes trial, people with type 2 di