Based on the available evidence, dipeptidyl peptidase‐4 inhibitors should be considered for hospitalized patients with type 2 diabetes and an algorithm for this is proposed (Figure 1). In relation to the use of GLP‐1 and GLP‐1 receptor agonist, further research is required to help define their role in the inpatient setting (Journal of Diabetes Investigation)
Diabetes News
Tag: DPP4 inhibitors
Cardiovascular outcome trials of glucose-lowering medications: an update
In summary, taking into account the findings from these new studies, it is suggested that a GLP-1RA should be offered to all people with CVD and type 2 diabetes, and SGLT2 inhibitors should be prescribed for those at high risk of heart failure or with progressive decline in eGFR. DPP4 inhibitors are a safe choice within the glucose-lowering stepped algorithm (Diabetologia)
Dipeptidyl peptidase‐4 inhibitor use is associated with decreased risk of fracture in patients with type 2 diabetes: a population‐based cohort study
The results of this study supported the premise that DPP‐4i usage is associated with a reduced risk of all‐cause fractures and upper extremity fractures in patients with type 2 diabetes (British Journal of Clinical Pharmacology)
Different Glucagon Effects During DPP-4 Inhibition versus SGLT-2 Inhibition in Metformin-Treated Type 2 Diabetes Subjects
We conclude that treatment with DPP-4 inhibition with vildagliptin results in 15% lower fasting and postprandial glucagon levels compared to SGLT-2 inhibition with dapagliflozin. DPP-4 inhibition also induces a more rapid insulin secretion and higher levels of intact incretin hormones resulting in stronger feedback inhibition of incretin hormone secretion than SGLT-2 inhibition (Diabetes, Obesity and Metabolism)
Second line initiation of insulin compared with DPP-4 inhibitors after metformin monotherapy is associated with increased risk of all-cause mortality, cardiovascular events, and severe hypoglycemia
Initiation of insulin, compared with DPP-4i treatment, was associated with an increased risk of subsequent all-cause mortality, fatal and nonfatal CVD, and severe hypoglycemia. Results from randomized trials will be important to elucidate causal relationships (Diabetes Research and Clinical Practice)
The Safety of Dipeptidyl Peptidase 4 Inhibitors and the Risk for Heart Failure
Owing to the well-documented microvascular benefit of improved glycemic control, the identification of cardiovascular-safe diabetes drugs that effectively lower glucose remains an important clinical need. The incretin therapies thus fulfill this goal. Ultimately, we need diabetes drugs that also reduce cardiovascular risk, and that will only be demonstrated through a continued commitment to long-term outcome studies (JAMA Cardiology)
Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus
Compared with sulfonylureas, DPP-4 inhibitors were associated with lower risks for all-cause death, MACEs, ischemic stroke, and hypoglycemia when used as add-ons to metformin therapy (Annals of Internal Medicine)
Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents
DPP-4 inhibitors were superior to placebo in reducing HbA1c levels in adults with T2DM taking at least two oral agents. Compared with placebo, no safety signals were detected with DPP-4 inhibitors and there was a reduced risk of infection. There was no significant difference in HbA1c observed between NPH and placebo or NPH and DPP-4 inhibitors (BMJ Open)
Glycosmedia is also available as an App: