The Role of DPP-4 Inhibitors in Type 2 Diabetes Mellitus

As the incidence of type 2 diabetes is steadily increasing, the demand for treatment options is increasing. Dipeptidyl peptidase-4 inhibitors (DPP-4) are a new class of oral anti-hyperglycemic medications that target the incretin system found in the gut. Evidence has shown that treatment with DPP-4 inhibitors has shown significant reductions in HbA1c and increased pancreatic ÃŽ ²-cell function without an increased risk of hypoglycemia. In this document, the pharmacology, clinical efficacy, and incidence of adverse effects will be reviewed in an attempt to target a patient population that would benefit the most from treatment with DPP-4 inhibitors. The role of DPP-4 inhibitors in type 2 diabetes mellitus management INTRODUCTION Type 2†¦show more content†¦In a study conducted by Herman et al in 2005, single oral doses of 1.5 mg to 600 mg were evaluated based on pharmacologic properties. Results of the study showed that plasma levels of sitagliptan are increased in relation to the dose administered. The half-life of sitagliptan ranges from 8-14 hours and peak levels are reached between 1-6 hours, also in a dose-dependent fashion. The percentage of inhibition of plasma DPP-4 levels was also increased with higher doses; however, 80% or more inhibition of DPP-4 was observed over a 24 hour period starting with a sitagliptan dose of 100 mg taken once daily. Additionally, the results of this study demonstrated that sitagliptan can be taken without regard to food.7 A summary of the results of the study can be found in Table 1. Sitagliptan is well-absorbed when taken orally and is primarily excreted through the renal system where approximately 80% remains unchanged in the urine.7,8 Therefore, circulating l evels of sitagliptan are increased in patients with moderate to severe renal insufficiency.7,8 The FDA has recommended that all patients with moderate to severe renal insufficiency who are considering starting sitagliptan should have a full assessment of renal function before starting the drug.9 Only minor increases in plasma drug levels8 and no increase in liver enzymes9 have been recognized in clinical trials of type 2 diabetic patientsShow MoreRelatedA Brief Note On Diabetes And The Treatment Of Type 1 Diabetes Mellitus921 Words   |  4 PagesReview Article Introduction: Type 1 diabetes, also known as insulin-dependent diabetes, is a chronic condition in which body produces little to no insulin due to autoimmune destruction of the beta cells of the pancreas. 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