DPP4 and Hypoglycemia: Combining DPP-4 inhibitors with metformin resulted in greater reductions in HbA1c (MD = −0.49) and FPG (MD = −0.80) but did not further reduce cardiovascular events (RR = 0.54), hypoglycemia (RR = 1.04), or gastrointestinal side effects (RR = 0.98) [123].