DPP4 and Hypoglycemia: Because the action of GLP-1 on insulin secretion is strictly glucose dependent, the risk of hypoglycaemia associated with DPP-4 inhibitors is low [9].The main elimination route of the first generation of approved DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin) is via the kidney [7], [10].