Gliptin versus a sulphonylurea as add-on to metformin

摘要

Inhibitors of dipeptidyl peptidase-4 (DPP-4), also called gliptins, offer a new approach in the management of type 2 diabetes.1 By inhibiting the enzyme that degrades glucagon-like peptide-1 (GLP-1) and thus increasing circulating plasma concentrations of this gastrointestinal hormone, they have a mechanism of action distinct from any existing oral glucose-lowering agent. As with other DPP-4 inhibitors (sitagliptin, vildagliptin, saxagliptin, and alogliptin), linagliptin improves glucose control both by increasing postprandial insulin secretion (the so-called incretin effect) and reducing glucagon secretion.