Why DPP-4 inhibitors (Gliptins) works so effectively in type 2 diabetes: What's new?

What is it about?

Incretin-based therapies (GLP-1 agonist and DPP-4 inhibitors) are playing a cornerstone role in treating type 2 diabetes today. While GLP-1 agonist are injectable preparation, DPP-4 inhibitors are oral drugs. It is widely perceived that DPP-4 inhibitors would be less effective, compared to GLP-1 agonist considering the robust rise of GLP-1 by the latter drugs. However, head-to-head studies finds interesting results. This article summarizes, how DPP-4I works so effectively.

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Why is it important?

This article discuss several mechanistic concept and discuss as to how DPP-4I might be working. The conventional concept of increasing endogenous GLP-1 by DPP-4I may not be the only reason behind the action of these drugs. Several other pathways seems to be working parallely to make this drug an effecting blood glucose lowering agent, even when beta cell may be minimal, especially in longstanding diabetes.