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

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Abstract

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.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Padua, Via Giustiniani 2, 35128, Padova, Italy

    G. Crepaldi MD

  2. Department of Pharmacology, Chemiotherapy and Medical Toxicology, LITA L. Sacco Hospital, School of Medicine, University of Milan, Milan

    M. Carruba

  3. Department of Internal Medicine, West Genoa Hospital, Genoa

    M. Comaschi

  4. Department of Endocrinology and Metabolism, University of Pisa, Pisa

    S. Del Prato

  5. Department of Internal Medicine, University of Rome Tor Vergata, Rome

    G. Frajese

  6. Departments of Geriatric and Metabolic Diseases, Experimental Medicine, and Clinical and Preventive Medicine, Second University of Naples, Naples, Italy

    G. Paolisso

Authors
  1. G. Crepaldi MD
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  2. M. Carruba
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  3. M. Comaschi
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  4. S. Del Prato
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  5. G. Frajese
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  6. G. Paolisso
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Correspondence to G. Crepaldi MD.

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Crepaldi, G., Carruba, M., Comaschi, M. et al. Dipeptidyl peptidase 4 (DPP-4) inhibitors and their role in Type 2 diabetes management. J Endocrinol Invest 30, 610–614 (2007). https://doi.org/10.1007/BF03346357

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  • DOI: https://doi.org/10.1007/BF03346357

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