|DPP-4 inhibitors, help maintain levels of the gut hormone GLP-l. When you eat, your small intestines secrete GLP-l, which then promotes insulin production by the pancreas. DPP-4 inhibitors breaks down GLP-l.
In people without diabetes, that's good because it prevents the overproduction of insulin. But people with diabetes often have a deficiency of GLP-l, so turning DPP-4 off will allow the GLP-l they do have to work longer in promoting insulin secretion.
Januvia (Sitagliptin) is the first DPP-4 inhibitor to be approved by the U.S. Food and Drug Administration. Several other DPP-4 inhibitors are likely to come to the market within the next few years.
DPP-4 inhibitors are being marketed as competition for sulfonylureas, but the burden of proof is on the companies that make this new class, Although DPP4 inhibitors don't cause low blood glucose or weight gain-older sulfonylureas may-whether they stack up against newer sulfonylureas remains to be seen. Overall, DPP-4 inhibitors appear not to be any more powerful, and perhaps less so than metformin and certain sulfonylureas. Again, cost rears its ugly head.
Yet DPP-4 inhibitors offer hope: Some animal studies suggest they may help the insulin producing beta cells in the pancreas survive and grow. There have not been any studies to determine if DPP-4 inhibitors might help preserve human beta cells, but the potential payoff cou1d be big, It would be a huge breakthrough in how we treat diabetes, we could then prescribe them early in the course of the disease to counteract the process.