The role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes mellitus

The role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes mellitus

T.Yu. Demidova, D.V. Skuridina

Pirogov Russian National Research Medical University, Moscow

Type 2 diabetes mellitus (DM2) is currently one of the major healthcare problems. Every year, the increasing morbidity rate, the development of late disabling complications from the cardiovascular and nervous systems, kidneys, and eyes significantly reduce the life expectancy and life quality of the population. They also put a huge burden on the healthcare system of all countries worldwide. As it is known, DM2 is a multifactorial disease. At present, a number of pharmacological agents have been developed affecting most of the pathogenetic factors for DM2 development, which increase the concentration of insulin in the blood (direct administration of insulin or its production stimulation), improve insulin sensitivity, delay the passage and absorption of carbohydrates from GIT, increase the excretion of glucose by the kidneys. Dipeptidyl peptidase-4 (DPP-4) inhibitors class or gliptins refers to agents with incretin activity. By inhibiting the DPP-4 enzyme in the patient’s blood, drugs of this class increase the biological activity of hormones — incretins (such as glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide), which increase insulin secretion and reduce glucagon production in response to food intake. Thus, by activating the incretin response, DPP-4 inhibitors affect one of the main DM2 pathogenetic links. This review examines the currently available data on the efficacy and safety of DPP-4 inhibitors in DM2 treatment and presents a new domestic drug of this class — Evogliptin.

Keywords: type 2 diabetes mellitus, glycated hemoglobin, glucagon-like peptide-1, glucose-dependent insulin secretion, dipeptidyl peptidase-4, dipeptidyl peptidase-4 inhibitors, incretins, antidiabetic medications.