DPP-4 is a protein that is associated with type 2 diabetes. Studies have shown that people who have a higher level of this in their blood have a higher risk of developing the disease.
On the other hand, DPP-4 inhibitors are drugs that can lower the level of DPP-4 in your blood and may help prevent type 2 diabetes from developing.
Increasing numbers of people across the globe are suffering from type-2 diabetes mellitus. Diabetes is a serious disease affecting over 23 million American adults and children (roughly 8% of the total population).
What is DPP-4?
What are DPP-4 inhibitors?
An oral diabetes drug class that is relatively new is the DPP-4 inhibitors. The drug is also referred to as gliptin and can be prescribed to diabetics who have failed to respond well to other diabetes medications, like metformin and sulphonylurea.
DPP-4 inhibitors are a class of prescription medicines used with diet and exercise to control high blood sugar in adults with type 2 diabetes. FDA-approved includes sitagliptin, saxagliptin, linagliptin, and alogliptin. They are available as single-ingredient products and in combination with other diabetes medicines such as metformin.
There are five DPP-4 inhibitors in the market today: sitagliptin, saxagliptin, linagliptin, alogliptin (in the United States and Europe), and vildagliptin (only available in Europe). Four more gliptins: teneligliptin, anagliptin, omarigliptin, and trelagliptin, are only approved in the Japanese and Korean markets.
How do DPP-4 inhibitors work?
What is Type 2 diabetes?
Type 2 diabetes mellitus is a disorder that affects how your body uses glucose (sugar); it can also impact how it stores and processes other forms of energy such as fat.
All cells require sugar for your body to function normally, and insulin helps transport sugar into your cells. Type 2 diabetes occurs when the body stops responding to normal or even high insulin levels. Over time, the pancreas (an organ in the abdomen) cannot produce enough insulin. When you are overweight, especially if you have fat stored in your liver and stomach, your body requires more insulin. High blood sugar (glucose) levels can lead to serious complications if left untreated.
With lifestyle changes, type 2 diabetes can usually be controlled. However, some people also require medication.
Symptoms of Type 2 diabetes
Frequent thirst.
Constant hunger.
Frequent urination.
Drying of the mouth.
Losing weight without trying.
Fatigue
Blurred Vision
Loss of Consciousness
A wound or infection that does not heal.
Red, swollen, tender gums.
Who should take DPP-4 inhibitors?
- DPP-4 inhibitors should not be used in place of metformin and sulphonylureas. Instead, they are best used together. It is considered an add-on drug therapy for patients who are inadequately controlled on metformin, a thiazolidinedione, or sulfonylurea.
- In patients with kidney disease or diabetes, DPP-4 inhibitors are not recommended.
- People with type 2 diabetes are prescribed this as a second or third line of treatment.
- Certain medications include antibiotics, antifungals, antiplatelets, proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), thiazide diuretics, or warfarin, DPP-4 inhibitors can cause liver damage and death.
Benefits of DPP-4 inhibitors for treating diabetes
DPP-4 inhibitors work by blocking the action of DPP-4, an enzyme that destroys the hormone incretin. Incretin helps the body produce more insulin only when needed and reduces the amount of glucose produced by the liver when it is not required.
Potential benefits include:
- Weight loss
- Renoprotective effects
- Decreasing blood glucose levels
- Lowering of BP
What are the side effects of DPP-4 inhibitors?
- Healthcare professionals should consider DPP-4 inhibitors as a possible cause of severe joint pain, and discontinue the drug if necessary.
- When type 2 diabetes occurs in adults, diet and exercise are used along with DPP-4 inhibitors to lower blood sugar levels. Type 2 diabetes can lead to severe complications, including blindness, damage to nerves and kidneys, and heart disease.
- Other side effects, besides severe joint pain, include inflammation of the pancreas, low blood sugar when combining this class of medicines with other prescription medicines prescribed to treat diabetes, and allergic reactions.
- The most common adverse reactions occurring in 5% of patients after taking DPP-4 inhibitors were: upper respiratory tract infection, nasopharyngitis, headache with sitagliptin and upper respiratory tract infection, urinary tract infection, and headache with saxagliptin.
- The most common adverse reactions occurring in 5% of patients after taking DPP-4 inhibitors were: upper respiratory tract infection, nasopharyngitis, headache with sitagliptin and upper respiratory tract infection, urinary tract infection, and headache with saxagliptin.
How do DPP-4 inhibitors treat type 2 diabetes?
This class of medicines, dipeptidyl peptidase-4 (DPP-4) inhibitors, includes sitagliptin (brand name: Januvia), saxagliptin (brand name: Onglyza), linagliptin (brand name: Tradjenta), alogliptin (brand name: Nesina), and vildagliptin (brand name: Galvus). Vildagliptin is available in some countries but not in the United States.
These medicines lower blood sugar levels by increasing the amount of insulin being released from the pancreas after eating a meal. They can be given alone to people who cannot tolerate the first-line medicine (metformin) or other medicines. They can be given together with other oral medications if blood sugar levels are still higher than the goal. These medicines do not cause hypoglycemia or changes in body weight. There have been rare reports of joint pain, pancreatitis, and severe skin reactions. DPP-4 inhibitors are expensive.
