DPP-4 Inhibitors: Similarities and Differences

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Expert Monograph: Issue 34

Author: Prof Merlin Thomas

DPP-4 Inhibitors: Similarities and Differences

Take home messages

Higher incretin levels achieved following DPP-4 inhibition trick the pancreas into secreting more insulin with a meal.

DPP-4 inhibitors are weight-neutral and do not significantly increase the risk of hypoglycaemia.

The cardiovascular safety of alogliptin, sitagliptin, saxagliptin and linagliptin has been established in long term cardiovascular outcome trials.

DPP-4 inhibitors are a safe and effective means to lower glucose levels in patients with renal impairment.

All DPP-4 inhibitors are associated with a modest increased risk of acute pancreatitis.

DPP-4 inhibitors are now subsidised across the Pharmaceutical Benefits Scheme (PBS) as dual and triple therapy, and when added to insulin.

DPP-4 inhibitors can be used as fixed-dose combinations with twice daily metformin, without any loss of efficacy.

This article discusses the evidence for the use of DPP-4 inhibitors, in addition to standard care, in the management of type 2 diabetes.

Written by Prof Merlin Thomas, MBChB, PhD, FRACP

Prof Merlin Thomas is a Professor of Medicine at Monash University, Melbourne. Professor Thomas is both a physician and a research scientist. He has published over 300 articles in many of the world’s leading medical journals, as well as several books including The Longevity List and Fast Living, Slow Ageing. He is internationally recognised as a speaker, opinion-leader, teacher and medical storyteller. His research focuses on discovering new ways to prevent and treat the complications of diabetes.


Click here to download the author’s competing interest statement.

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