DPP-4 Inhibitors

DPP-4 inhibitors are oral medications used to treat type 2 diabetes by blocking the DPP-4 enzyme to lower blood sugar levels. They’re often combined with other medicines and diabetic drugs.

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Digestion and Incretins

Incretins are a class of hormones that play an important role in regulating blood sugar (glucose) levels, particularly during and after meals. They are released from the gastrointestinal tract in response to meal consumption and aid in modulating several processes of digestion and glucose metabolism. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) are two of the most well-known incretins.

Here’s how incretins play a role in digestion and glucose regulation:

1. Insulin Secretion Stimulation: Incretins, particularly GLP-1 and GIP, stimulate the pancreas to secrete insulin when released in response to meal consumption. Insulin is a hormone that promotes glucose uptake into cells, including muscle and fat cells, as well as lowering blood sugar levels. This insulin release is known as the “incretin effect.”

2. Glucagon secretion inhibition: Incretins also reduce glucagon secretion from the pancreas. Glucagon is a hormone that promotes the release of glucose from the liver, hence raising blood sugar levels. Incretins serve to decrease glucagon secretion, which helps to lower blood sugar after meals.

3. Slowing Gastric Emptying: GLP-1 can slow stomach emptying, which means food stays in the stomach longer before going into the small intestine. This delayed stomach emptying can help manage the rate of glucose absorption from the digestive tract into the circulation, minimizing blood sugar rises.

4. Appetite Regulation: Incretins may influence appetite regulation in addition to their effects on glucose metabolism. GLP-1, in particular, has been found to produce a sense of fullness or satiety, which may aid in weight management by reducing food consumption.

Incretins are hormones released from the gastrointestinal system in response to food consumption, and they play an important role in blood sugar regulation by increasing insulin secretion, decreasing glucagon release, slowing gastric emptying, and potentially altering hunger. These systems work together to keep blood sugar levels within a healthy range, especially after meals. However, in illnesses such as type 2 diabetes, the incretin response may be impaired, which is why drugs such as DPP-4 inhibitors and GLP-1 receptor agonists are used to improve blood sugar control by enhancing the incretin impact.

What exactly is DPP-4?

DPP-4, also known as Dipeptidyl Peptidase-4, is an enzyme found in the human body that helps to regulate blood sugar levels. DPP-4 is an enzyme found in many cells and tissues throughout the body, including the immune system, the gastrointestinal tract, and endothelial cells. DPP-4 is involved in a variety of physiological processes and serves a number of tasks in the body, including incretin degradation.

DPP-4’s participation in the breakdown of incretin hormones is one of its well-known functions. Incretins, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), are hormones secreted by the intestine in response to meal consumption. They stimulate pancreatic insulin release while suppressing glucagon release, both of which help manage blood sugar levels. DPP-4 destroys incretin hormones, reducing their duration of effect.

What exactly are DDP-4 inhibitors?

DPP-4 inhibitors are a type of medicine that is often used to treat type 2 diabetes. These drugs function by blocking the action of DPP-4, which raises blood levels of active incretins like GLP-1 and GIP. This results in increased insulin secretion and decreased glucagon release, thereby lowering blood sugar levels after meals.

DPP-4 inhibitors (gliptins) are a type of oral hypoglycemic medication that inhibits the enzyme dipeptidyl peptidase-4 (DPP-4). They can be used to treat type 2 diabetes.

Sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), and alogliptin (Nesina) are examples of DPP-4 inhibitors. These medications are normally taken orally and are frequently administered in conjunction with other diabetes medications as part of a comprehensive treatment plan for type 2 diabetes.

DPP-4 inhibitors help regulate blood glucose levels by shielding incretins from destruction.


Overall, higher insulin production, decreased glucagon release, and slower stomach emptying result in better blood sugar control, especially after meals. DPP-4 inhibitors are frequently used as adjunct therapy alongside other diabetes drugs to help people with type 2 diabetes regulate their blood sugar levels.

  • Weight-Neutral: Unlike some other diabetic drugs, DPP-4 inhibitors are generally regarded as weight-neutral, which means they do not often induce major weight changes.
  • Low chance of hypoglycemia: When compared to other diabetic drugs, DPP-4 inhibitors have a lower chance of inducing hypoglycemia (low blood sugar), making them a relatively safe alternative for many people.

While DPP-4 inhibitors can help manage blood sugar levels, they are not appropriate for everyone with type 2 diabetes, and their usage should be assessed by a healthcare provider based on an individual’s medical history and needs. DPP-4 inhibitors, like all drugs, may have negative effects that should be discussed with a healthcare provider.

Brands of DPP-4 inhibitors you can buy in the USA

Several DPP-4 inhibitor drugs were accessible in the United States as of my most recent knowledge update in September 2021. These drugs are prescribed to patients with type 2 diabetes. However, it’s important to note that medicine availability might change over time, and new medications may have been introduced after my last update. For the most up-to-date information on available drugs, always consult a healthcare provider or pharmacist. As of my latest update, the following common DPP-4 inhibitor drugs were accessible in the United States:

1. Sitagliptin: Januvia is the brand name for this medication.

2. Saxagliptin: Generic name: Onglyza

3. Linagliptin: Tradjenta is the brand name.

4. Alogliptin: Generic name: Nesina

Teneligliptin (licensed in some countries but not available in the United States)

Vildagliptin (available in several countries but not the United States)

Please bear in mind that availability varies by location and is subject to change owing to governmental approvals, marketing, and other considerations. Working with a healthcare practitioner to determine the most appropriate medicine for your unique situation and staying up-to-date on the latest discoveries in diabetes management is critical. Your healthcare practitioner can advise you on which medications, if any, are appropriate for your requirements and circumstances.