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Cohort studies and managed care data analysis of insulin pen usage compared with vial and syringe users, confirm which of the following:
a. Insulin pen users have significantly fewer hospitalizations and diabetes-related hospitalization, although hypoglycemia-associated health care utilization remains unchanged.
b. Hospitalizations and diabetes-related hospitalization frequency are approximately the same in all categories of users.
c. Insulin pen users have significantly fewer hospitalizations and diabetes-related hospitalization, and hypoglycemia-associated health care utilization.
d. Insulin pen users have significantly fewer hypoglycemia-associated health care utilization, although frequency of hospitalizations and diabetes-related hospitalization did not change.

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