Newer antihyperglycaemic agents (AHA) like DPP4i, GLP1RA, and SGLT2i show a lower risk of hypoglycaemia compared to traditional treatments like sulfonylurea or insulin, but their risk against placebo was unclear.
A systematic review analyzed trials over 12 weeks to evaluate the risk of both any and severe hypoglycaemia associated with AHA and metformin compared to placebo.
Results indicated that AHA did not significantly increase hypoglycaemia risk whether used alone or with metformin, while metformin alone and early dual therapy initiation raised the risk of any hypoglycaemia.