There were too few events to compare DPP4 inhibitor initiators to metformin initiators; however, when DPP4 inhibitor use was not associated with an increased or decreased risk of acute pancreatitis when compared to metformin in a time-varying model (adjusted HR = 1.51; 95% CI 0.48–4.75). Here, DPP4 is linked to acute pancreatitis.