USMLE

DPP-4 Inhibitors

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Diabetes Drugs
  1. Insulin Preparations
  2. Metformin
  3. Glitazones / Thiazolidinediones
  4. First-Gen Sulfonylureas
  5. Second-Gen Sulfonylureas
  6. Meglitinides
  7. GLP-1 Analogs
  8. DPP-4 Inhibitors
  9. alpha-Glucosidase Inhibitors
  10. Pramlintide

Summary

DPP-4 inhibitors are drugs used in the treatment of type 2 diabetes. They work by inhibiting the degradation of incretins—notably GLP-1. GLP-1 leads to glucose-dependent insulin release, which has a decreased risk of causing hypoglycemia because it only releases insulin when glucose levels are high. Last but not least, DPP-4 inhibitors may cause mild urinary and respiratory infections.

Key Points

  • DPP-4 Inhibitors
    • Drugs end in -gliptin
      • Linagliptin
      • Saxagliptin
      • Sitagliptin
      • Alogliptin
    • Clinical Use
      • Type II Diabetes
    • Mechanism
      • DPP-4 inhibition → increased incretins
        • Increased GLP-1
        • Also increases GIP and other off-targets
      • Increase glucose-dependent insulin release
      • Decrease glucagon release
      • Delay gastric emptying
      • Increase satiety
    • Adverse Effects
      • Mild urinary / respiratory infections
      • Generally weight neutral (i.e. no weight gain)