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Journal Article Review Ppublish 43 citations

PubMed: 35211246 DOI: 10.4239/wjd.v13.i2.85

Role of dipeptidyl peptidase 4 inhibitors in the new era of antidiabetic treatment.

World J Diabetes 13(2):85-96

Authors: Matilda Florentin, Michael S Kostapanos, Athanasia K Papazafiropoulou

Affiliations

  • Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina 45221, Greece.
  • Lipid Clinic, Department of General Medicine, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom.
  • 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Athens 18536, Greece.

Abstract

The last few years important changes have occurred in the field of diabetes treatment. The priority in the therapy of patients with diabetes is not glycemic control per se rather an overall management of risk factors, while individualization of glycemic target is suggested. Furthermore, regulatory authorities now require evidence of cardiovascular (CV) safety in order to approve new antidiabetic agents. The most novel drug classes, , sodium-glucose transporter 2 inhibitors (SGLT2-i) and some glucagon-like peptide-1 receptor agonists (GLP-1 RA), have been demonstrated to reduce major adverse CV events and, thus, have a prominent position in the therapeutic algorithm of hyperglycemia. In this context, the role of previously used hypoglycemic agents, including dipeptidyl peptidase 4 (DPP-4) inhibitors, has been modified. DPP-4 inhibitors have a favorable safety profile, do not cause hypoglycemia or weight gain and do not require dose uptitration. Furthermore, they can be administered in patients with chronic kidney disease after dose modification and elderly patients with diabetes. Still, though, they have been undermined to a third line therapeutic choice as they have not been shown to reduce CV events as is the case with SGLT2-i and GLP-1 RA. Overall, DPP-4 inhibitors appear to have a place in the management of patients with diabetes as a safe class of oral glucose lowering agents with great experience in their use.

MeSH

Diabetes Mellitus, Glucagon-Like Peptide 1, Dipeptidyl Peptidase 4, Safety, Dipeptidyl-Peptidase Iv Inhibitors, Peptide Hydrolases, Therapeutics, Hypoglycemic Agents

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