DPP-4 inhibitors are a type of medication that people with type 2 diabetes can use to lower blood sugar levels.
How do DPP-4 inhibitors work?
DPP-4 is an enzyme (a natural chemical) that breaks down hormone GLP-1. GLP-1 helps the body lower blood sugar levels by causing the pancreas to produce insulin after a meal. So, more GLP-1 means more insulin production and lower glucose levels. One way to increase levels of GLP-1 is by reducing levels of DPP-4. DPP-4 inhibitors lead to more GLP-1 that lasts longer in the bloodstream; this stimulates insulin production and decreases production of glucagon when glucose levels are high, lowering the body’s glucose levels.
Who uses DPP-4 inhibitors?
DPP-4 inhibitors are used by people with type 2 diabetes. This medication is generally not the first drug prescribed to lower glucose levels. Some people add DPP-4s onto existing metformin therapy or take DPP-4s alone or with other drugs.
What are the benefits?
DPP-4s have a low risk of hypoglycemia (low blood sugar) unless used together with sulfonylureas or insulin. Other drugs (such as sulfonylureas) have a higher risk of hypoglycemia, a major side effect of many glucose-lowering medications.
DPP-4 is an oral drug (a pill) so there’s no need for injections.
Studies show that DPP-4 is weight neutral and will not lead to an increase in weight.
What are the drawbacks?
DPP-4s are not as effective as GLP-1 agonist medications. While DPP-4s have fewer side effects, they provide less glucose control, weight loss, and overall treatment satisfaction.
DPP-4s are more expensive than some other diabetes drugs like sulfonylureas and metformin.
Commonly used DPP-4 drugs:
Galvus (vildagliptin) – not approved in US
Last updated: August 2, 2021