Journal of Diabetes Research / 2015 / Article / Tab 1

Review Article

The Place of Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Therapeutics: A “Me Too” or “the Special One” Antidiabetic Class?

Table 1

Main features of non-incretin-based antidiabetic drugs for T2DM treatment.

ClassMechanisms of actionEffects/advantagesAdverse reactionsΔHbA1c (−%)

BiguanidesDecrease hepatic glucose production and gluconeogenesis
Decrease intestinal glucose absorption
Increase peripheral glucose utilization
Reduce blood glucose levels in hyperglycaemic state only
Reduce lipid levels
Cause modest reduction of body weight
Perform oral administration
Nausea and vomiting
Diarrhoea
Lactic acidosis
1.0–2.0

SulfonylureasIncrease pancreatic insulin secretion
Decrease or unchanged plasma insulin levels
Reduce blood glucose levels in hyperglycaemic and normoglycemic states
Increase plasma insulin levels
Perform oral administration
Increased body weight
Hypoglycaemia
Nausea and vomiting
1.0–2.0

ThiazolidinedionesDecrease hepatic glucose production and gluconeogenesis
Increase peripheral glucose utilization
Reduce blood glucose levels in hyperglycaemic state only
Reduce lipid levels (triglycerides)
Have possible benefits on cardiovascular risk factors
Perform oral administration
Increased body weight
Anaemia
Oedema
Congestive heart failure in susceptible individuals
0.5–1.4

MeglitinidesIncrease pancreatic insulin secretionReduce blood glucose levels in hyperglycaemic and normoglycemic states
Reduce postprandial glucose excursions
Have no significant effects on lipid levels
Perform oral administration
Hypoglycaemia
Increased body weight 
Diarrhoea
0.5–1.5

α-glucosidase inhibitorsPerform reversible inhibition of α-glucosidase enzymes
Decrease digestion of complex carbohydrates
Delay glucose absorption
Reduce blood glucose levels in hyperglycaemic state only
Have no significant effects on lipid levels
Have no effects on body weight
Perform oral administration
Abdominal pain
Elevation of liver enzymes
Diarrhoea
0.5–0.8

Sodium-glucose cotransporter 2 inhibitorsPerform inhibition of renal reabsorption of glucose, thus increasing urinary glucose excretionReduce plasma glucose
Have beneficial effects on body weight and blood pressure
Have low risk of hypoglycaemia
Risk of urinary and genital tract infections Requirement of regular monitoring of renal function and kalemia0.5–0.8

InsulinReplace endogenous insulin Reduce blood glucose levels in hyperglycaemic and normoglycemic states
Perform subcutaneous administration
Hypoglycaemia
Increased body weight
1.5–3.5

HbA1c variations (negative %) are mean values.

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