Dipeptidyl peptidase-4 inhibitors in type 2 diabetes
| Author : Pierre Allain
||Date : 2012-4-21
Dipeptidyl dipeptidase-4 inhibitors, also called - gliptines are used for the treatment of type 2 diabetes mellitus.
The BMJ March 2012 published a review of the literature with meta-analysis about dipeptidyl dipeptidase-4 inhibitors, DPP-4 inhibitors. This study leads to the following results:
On glycated haemoglobin level, DPP-4 inhibitors
- used as monotherapy are less effective than metformin
- used in combination with metformin are less effective than glucagon-like peptide-1, GLP-1 agonists, and about equivalent to sulfonylureas and pioglitazone (the latter is not marketed longer in France but is in the rest of the world).
On body weight, DPP-4 inhibitors,
- used as monotherapy, cause lesser weight loss than metformin;
- used in combination with metformin, they induce more weight loss than sulfonylureas and pioglitazone but lesser than GLP-1 agonists.
The authors conclude that in the type 2 diabetes patients, when metformin alone does not lower sufficiently the level of glycated hemoglobin, DPP- 4 inhibitors prescribed in addition induce a decrease of glycated haemoglobin approximately equivalent to that of sulfonylureas and pioglitazone, without effect on body weigh, but at a higher cost and with uncertainties about their long-term safety.