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Research and Reviews: A Journal of Pharmacology Review Article

Practical approach for Type 2 Diabetes: Role of DPP4 Inhibitors

  1. Abhijit Trailokya Indoco Remedies, Mumbai
  2. Sunil Chaudhry Solutions and Consultant, Edenwell Therapeutics Private Limited Mumbai

Abstract

Dipeptidyl peptidase-4 inhibitors (DPP-4Is) have become essential in managing type 2 diabetes mellitus (T2DM) due to their ability to enhance incretin hormone activity, which promotes insulin secretion and inhibits glucagon release. These agents effectively lower HbA1c levels by 0.5–1.0%, are weight-neutral, and have a low risk of hypoglycemia, making them suitable for a broad patient population, including the elderly. The antidiabetic market in India is vast. Gliptin as group row at rate of 40%, the market size is INR 1800 crores. Common DPP-4 inhibitors include alogliptin, sitagliptin, saxagliptin, teneligliptin and linagliptin, each with unique pharmacokinetic profiles. While generally well-tolerated, rare adverse effects such as pancreatitis and joint pain have been reported. Gliptins in terms of efficacy are non-inferior to sulfonylurea and metformin and are well tolerated. DPP-4 inhibitors are administered orally, once daily (except vildagliptin), before or after meals. Gliptins result in modest improvement in HbA1c, with a reduction of around 0.5–1.0% when used as monotherapy and around 0.6–1.1% when used in combination with metformin, depending on the agent, dose of therapy and starting HbA1c. Recent developments highlight the increasing use of DPP-4 inhibitors in combination therapies with other antidiabetic agents, such as SGLT2 inhibitors, to optimize glycemic control and provide additional benefits like weight loss and cardioprotection (except saxagliptin).

Keywords

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