Dipeptidyl peptidase-4 inhibitor

Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors or gliptins) are a class of medicine used to treat Type 2 diabetes. They work by blocking the action of Dipeptidyl peptidase-4 (DPP-4), an enzyme which destroys the hormone incretin. Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. These two actions lower blood glucose levels.

Mechanism of Action

DPP-4 inhibitors work by blocking the action of DPP-4, an enzyme which destroys the hormone incretin. Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. This mechanism of action is unique to DPP-4 inhibitors, and it has a glucose-dependent effect, meaning it increases insulin secretion and decreases glucagon secretion only when glucose levels are elevated.

Types of DPP-4 Inhibitors

There are several types of DPP-4 inhibitors available, including:

• Sitagliptin (Januvia)
• Saxagliptin (Onglyza)
• Linagliptin (Tradjenta)
• Alogliptin (Nesina)

Each of these medications works in the same way, but they have different chemical structures.

Side Effects

Like all medications, DPP-4 inhibitors can cause side effects. The most common side effects include:

• Nasopharyngitis (common cold)
• Headache
• Nausea
• Skin rash

In rare cases, DPP-4 inhibitors can cause pancreatitis (inflammation of the pancreas).

Contraindications

DPP-4 inhibitors should not be used in people with type 1 diabetes or for the treatment of diabetic ketoacidosis. They are also not recommended for use in people with severe kidney disease.

See Also

• Type 2 diabetes
• Incretin
• Insulin
• Glucagon