DPP-4 inhibitors, or dipeptidyl peptidase-4 inhibitors, are a class of medications used primarily in the treatment of type 2 diabetes. These drugs work by inhibiting the enzyme DPP-4, which breaks down incretin hormones like GLP-1 (glucagon-like peptide-1). Incretins play a role in stimulating insulin release from the pancreas and inhibiting glucagon secretion, both of which help regulate blood sugar levels.
By inhibiting DPP-4, these medications increase the levels of active incretin hormones, which helps control blood sugar levels after meals and throughout the day.
Common DPP-4 Inhibitors:
- Sitagliptin (Januvia)
- Saxagliptin (Onglyza)
- Linagliptin (Tradjenta)
- Alogliptin (Nesina)
Benefits:
- Lower blood sugar levels: They help reduce post-meal blood glucose spikes.
- Low risk of hypoglycemia: DPP-4 inhibitors typically do not cause low blood sugar (hypoglycemia) when used alone.
- Weight neutral: They generally don’t cause weight gain, unlike some other diabetes medications.
- Convenient: These medications are usually taken once daily with or without food.
Side effects:
While generally well-tolerated, DPP-4 inhibitors can cause some side effects, including:
- Upper respiratory tract infections
- Headache
- Nasopharyngitis (inflammation of the nasal passages and throat)
- Gastrointestinal discomfort (nausea, abdominal pain)
Rarely, they can cause serious side effects such as:
- Pancreatitis (inflammation of the pancreas)
- Severe allergic reactions
- Joint pain or inflammation
Mechanism of Action:
- Inhibition of DPP-4: DPP-4 normally breaks down incretin hormones, so inhibiting it enhances the body’s ability to release insulin in response to meals and suppresses the release of glucagon, which helps lower blood glucose levels.
These medications are often used in combination with other anti-diabetic drugs, like metformin or SGLT2 inhibitors, to help control blood sugar levels in people with type 2 diabetes.