| Abstract: |
New research highlighting the role of incretin hormones in beta cell function, growth, and development shows potential to provide clinical benefit to patients and to expand the current treatment options for managing type 2 diabetes. This chapter on the DPP-4 inhibitors is from a monograph on the clinical impact of incretin-based therapies on the management of people with type 2 diabetes. The monograph is based on a continuing education symposium that was held in conjunction with the American Association of Diabetes Educators’ 2005 Annual Meeting. The authors describe DPP-4 inhibitors, which are used to prolong the effect of endogenous glucagon-like peptide (GLP-1); one of the DPP-4 inhibitors under study is called vildagliptin. These drugs inhibit DPP-4, so GLP-1 concentrations rise, resulting in benefits similar to a direct infusion of GLP-1. Vildagliptin decreases blood glucose levels, increases active GLP-1, decreases glucagon, and lowers glycosylated hemoglobin (A1C) with once-daily oral dosing. The chapter concludes with a discussion of sitagliptin, another DPP-4 inhibitor that was approved for treatment in type 2 diabetes mellitus in October 2006. One table summarizes the approval status, route and effective dose, and adverse effects of four incretin therapies: exenatide, liraglutide, vildagliptin, and sitagliptin. 3 figures. |