INS and diabetes mellitus: In patients with diabetes who used metformin but who did not use neither insulin nor sulfonylurea at baseline (n = 593), there were only nine first hypoglycemic adverse events and there was not a significantly higher risk for hypoglycemic adverse events in the sacubitril/valsartan group (2.0% vs. 1.0%; HR 1.92, 95% CI 0.48–7.69, P = 0.36).