INS and Hyperglycemia: In this report, agents with beta cell stimulating effects, including a dipeptidylpeptidase-4 inhibitor, a sulfonylurea, and a glucagon-like peptide-1 receptor agonist were associated with progressive hyperglycemia, whereas treatment with metformin, decreasing the need for insulin, led to HbA1c of less than 6.5% (48 mmol/mol) after 6 months of treatment (3).