Which medications in the drug class Antidiabetics, Dipeptyl Peptidase-IV Inhibitors are used in the treatment of Diabetic Nephropathy?

Updated: Oct 09, 2019
  • Author: Vecihi Batuman, MD, FASN; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Antidiabetics, Dipeptyl Peptidase-IV Inhibitors

The dipeptidyl peptidase (DPP)–4 inhibitors (ie, gliptins) are a new class of antidiabetic agents that can be used in type 2 diabetes. They decrease the breakdown of the incretin hormones, such as glucagonlike peptide 1 (GLP-1). GLP-1 is secreted by the GI tract in response to food intake and leads to insulin secretion in a glucose-dependent manner, while also decreasing glucagon release. GLP-1 also slows gastric emptying.

Sitagliptin (Januvia)

Sitagliptin blocks the enzyme DPP-4, which is known to degrade incretin hormones. It increases concentrations of active intact incretin hormones (GLP-1 and GIP). The hormones stimulate insulin release in response to increased blood glucose levels following meals. This action enhances glycemic control. Sitagliptin is indicated for diabetes type 2 as monotherapy or combined with metformin or a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist (eg, thiazolidinediones).

Linagliptin (Tradjenta)

Linagliptin increases and prolongs incretin hormone activity, which are inactivated by DPP-4 enzyme Incretins regulate glucose homeostasis by increasing insulin synthesis and release from pancreatic β cells and reducing glucagon secretion from pancreatic α cells.

Saxagliptin (Onglyza)

Saxagliptin blocks the enzyme DPP-4, which is known to degrade incretin hormones. It increases concentrations of active intact incretin hormones (GLP-1 and GIP). The hormones stimulate insulin release in response to increased blood glucose levels following meals. This action enhances glycemic control. Saxagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 DM.

Alogliptin (Nesina)

Alogliptin slows inactivation of incretin hormones (eg, GLP-1, GIP), thereby reducing fasting and postprandial glucose concentrations in a glucose-dependent manner


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