In summary, in patients with pasireotide-related hyperglycaemia we suggest starting GLP1-RA and metformin as a first-line approach and avoiding DPP4-i, in accordance with the findings of the previous studies (120, 121) and to the mild anti-hyperglycaemic effects of DPP4-i (Figure 3). This evidence concerns the gene GCG and Hyperglycemia.