In three studies within the Ingenix (now Optum) administrative claims database [33-35], patients treated with sitagliptin, another DPP-4 inhibitor, were more likely to have medical comorbidities (i.e., cardiovascular disease, chronic kidney disease, hypertension, lipid disorders, and neuropathy) and were more frequently prescribed cardiovascular medications and insulin. Here, INS is linked to chronic kidney disease.