Journal of Endocrinological Investigation

, Volume 30, Issue 7, pp 610–614 | Cite as

Dipeptidyl peptidase 4 (DPP-4) inhibitors and their role in Type 2 diabetes management

  • G. Crepaldi
  • M. Carruba
  • M. Comaschi
  • S. Del Prato
  • G. Frajese
  • G. Paolisso
Short Review


Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new pharmacological class of drugs for treating Type 2 diabetes. They improve the capacity of the organism to control glycemia by increasing the levels of active incretins. Their mechanism of action is thus radically different from those of other anti-diabetic drugs currently available. DDP-4 inhibitors use a physiological mechanism to control hyperglycemia, by stimulating the secretion of insulin from β-cells, decreasing the secretion of glucagon from pancreatic α-cells, and at the same time reducing the production of glucose by the liver. DDP-4 inhibitors have shown significant efficacy in maintaining reduced levels of glycosylated hemoglobin for up to 1 year. In vitro and animal studies have shown that they can inhibit apoptosis of β-cells and favor their regeneration and differentiation. The oral DPP-4 inhibitors vildagliptin, sitagliptin, and saxagliptin are efficacious both alone and in association with other oral anti-diabetic agents and may be administered in a single daily dose. Lastly, they have substantial advantages with respect to other anti-diabetic drugs, since they involve a low risk of hypoglycemia and do not affect body weight.


Incretins insulin secretion Type 2 diabetes 


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Copyright information

© Italian Society of Endocrinology (SIE) 2007

Authors and Affiliations

  • G. Crepaldi
    • 1
  • M. Carruba
    • 2
  • M. Comaschi
    • 3
  • S. Del Prato
    • 4
  • G. Frajese
    • 5
  • G. Paolisso
    • 6
  1. 1.Department of Medical and Surgical SciencesUniversity of PaduaPadovaItaly
  2. 2.Department of PharmacologyChemiotherapy and Medical Toxicology, LITA L. Sacco Hospital, School of Medicine, University of MilanMilan
  3. 3.Department of Internal MedicineWest Genoa HospitalGenoa
  4. 4.Department of Endocrinology and MetabolismUniversity of PisaPisa
  5. 5.Department of Internal MedicineUniversity of Rome Tor VergataRome
  6. 6.Departments of Geriatric and Metabolic Diseases, Experimental Medicine, and Clinical and Preventive MedicineSecond University of NaplesNaplesItaly

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