In patients with diabetes who used metformin but who did not use neither insulin nor sulfonylurea at baseline (n = 1035) there were 16 first hypoglycemic adverse events and there was not a significantly higher risk for hypoglycemic adverse events in the sacubitril/valsartan group (1.9% vs. 1.2%; HR 1.57, 95% CI 0.57–4.31, P = 0.39). This evidence concerns the gene INS and diabetes mellitus.