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01-06-2019 | Alogliptin | Review Article

Ten years of experience with DPP-4 inhibitors for the treatment of type 2 diabetes mellitus

Authors: Giorgio Sesti, Angelo Avogaro, Sara Belcastro, Benedetta Maria Bonora, Marina Croci, Giuseppe Daniele, Marco Dauriz, Francesco Dotta, Caterina Formichi, Simona Frontoni, Cecilia Invitti, Emanuela Orsi, Fabiana Picconi, Veronica Resi, Enzo Bonora, Francesco Purrello

Published in: Acta Diabetologica | Issue 6/2019

Abstract

Achieving and maintaining recommended glycemic targets without causing adverse e ffects, including hypoglycemia, is challenging, especially in older patients with type 2 diabetes mellitus (T2DM). The introduction of dipeptidyl peptidase-4 (DPP-4) inhibitors, more than 10 years ago, has provided an alternative to conventional medications for the intensification of glucose-lowering treatment after failure of metformin monotherapy, and therefore, marked an important advance in the management of T2DM. By prolonging the activity of incretin hormones, DPP-4 inhibitors induce insulin release and decrease glucagon secretion in a glucose-dependent manner. This results in a more physiologic glycemic control as compared to that ensured by insulin secretagogues (sulfonylureas and glinides). Overall, DPP-4 inhibitors have a favorable safety profile and can be used without dose adjustments in older adults and in patients with mild renal impairment; they have a neutral effect on body weight and do not cause hypoglycemia by themselves. Safety issues, reported mainly in post-marketing surveillance programs and including cardiovascular outcomes and the risk of acute pancreatitis, are being extensively investigated. The aim of this review is to discuss the impact of DPP-4 inhibitors on the treatment of T2DM, after 10 years of experience, with an emphasis on diabetes care in Italy. We will first describe T2DM treatment in Italy and then provide an overview of the main findings from randomized controlled trials, real-world studies and post-marketing surveillance programs with DPP-4 inhibitors.

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Title: Ten years of experience with DPP-4 inhibitors for the treatment of type 2 diabetes mellitus
Authors: Giorgio Sesti
Angelo Avogaro
Sara Belcastro
Benedetta Maria Bonora
Marina Croci
Giuseppe Daniele
Marco Dauriz
Francesco Dotta
Caterina Formichi
Simona Frontoni
Cecilia Invitti
Emanuela Orsi
Fabiana Picconi
Veronica Resi
Enzo Bonora
Francesco Purrello
Publication date: 01-06-2019
Publisher: Springer Milan
Keywords: Alogliptin
Sitagliptin
Sulfonylurea
Insulins
Acute Pancreatitis
Metformin
Vildagliptin
Saxagliptin
Hypoglycemia
Linagliptin
Diabetes
Insulins
DPP-4-Inhibitor
Type 2 Diabetes
Published in: Acta Diabetologica / Issue 6/2019
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-018-1271-3

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Keynote webinar | Spotlight on medication adherence

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Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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Other articles of this Issue 6/2019

Relationship between health care insurance status, social determinants and prevalence of diabetes-related microvascular complications in patients with type 1 diabetes: a nationwide survey in Brazil

Spousal diabetes status as a risk factor for incident type 2 diabetes: a prospective cohort study and meta-analysis

Long-term outcomes after intravitreal dexamethasone treatment in steroid responders

Nutritional markers in patients with diabetes and pancreatic exocrine failure

Cross-talk between fetal membranes and visceral adipose tissue involves HMGB1–RAGE and VIP–VPAC2 pathways in human gestational diabetes mellitus

A common polymorphism in MIR155 gene promoter region is associated with a lower risk to develop type 2 diabetes

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials