This is a study to determine whether glycemic control, as measured by change in HbA1c and
frequency of hypoglycemia, is different between treatment with linagliptin (Tradjenta®) and
basal insulin in long term care residents(LTC) with Type 2 diabetes(T2D). Patients with
poorly controlled diabetes (HbA1c >7.5%) will be randomized to a 6-month intervention with
linagliptin or glargine insulin (± metformin for both treatments). Our hypothesis is that
treatment with linagliptin, a once daily DPP4-inhibitor, will result in similar improvement
in glucose control but in a lower rate of hypoglycemia than insulin treatment in LTC
residents with T2D. We will also determine differences in clinical outcome, resource
utilization, and hospitalization costs between LTC residents with T2D treated with
linagliptin and basal and correction insulin. We will compare differences in complications
(infectious and non-infectious, neurological and cardiovascular events), emergency room
visits and hospitalizations between groups during the 6 months of intervention.