The ultralong-acting insulin analogue insulin degludec (Tresiba) may be associated with fewer hypoglycemic episodes than insulin glargine U100 (Lantus) when used as basal insulin in type 1 and type 2 diabetics. In two industry-sponsored studies, type 1 diabetics (n = 501) and type 2 diabetics (n = 721) were randomized to insulin degludec followed by insulin glargine U100, or the reverse, for two 32-week treatment periods that included a 16-week titration and 16-week maintenance period. All patients had at least one risk factor for hypoglycemia. For the type 1 group, insulin degludec resulted in fewer hypoglycemic episodes (2,200.9 vs. 2,467.7 per person-years’ exposure; P < 0.001 for both noninferiority and superiority). In the type 2 group, insulin degludec also resulted in fewer hypoglycemic episodes (185.6 vs. 265.4 per person-years’ exposure, rate ratio 0.70; 95% confidence interval, 0.61-0.80; P < 0.001). A1c and fasting blood sugar levels were the same in both groups in both studies. The authors of the two studies suggested that 32 weeks’ treatment with insulin degludec vs. insulin glargine U100 resulted in a reduced rate of overall symptomatic hypoglycemic episodes. (JAMA 2017;318:33-44 and JAMA 2017;318:45-56)