Drugs for diabetes: part 5 DPP-4 inhibitors

The dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of oral drugs for the treatment of type 2 diabetes. They inhibit the breakdown of glucagon-like peptide-1 (GLP-1) and increase the incretin effect in patients with type 2 diabetes. In clinical practice they are associated with significant reductions in HbA1c, no weight gain and a low risk of hypoglycaemia. Initial cardiovascular safety studies have shown no increase in cardiovascular risk. Indeed, the suggestion of possible cardiovascular benefit seen in the safety studies is now being formally examined in large randomised-controlled trials with primary cardiovascular end points