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The dipeptidyl peptidase-4 inhibitors in type 2 diabetes mellitus: cardiovascular safety.

Publication ,  Journal Article
Green, JB
Published in: Postgrad Med
July 2012

The dipeptidyl peptidase-4 (DPP-4) inhibitors are a relatively new class of oral antidiabetic agents that improve glycemic control in patients with type 2 diabetes mellitus. These agents differ in structure, but all act by inhibiting the DPP-4 enzyme. Dipeptidyl peptidase-4 inhibition increases levels of the incretin hormones glucagon-like peptide-1 and glucose-dependent insulinotropic peptide, which in turn stimulate insulin secretion in a glucose-dependent fashion. Clinical trials have shown that DPP-4 inhibitors provide significant reductions in glycated hemoglobin levels, with a low risk of hypoglycemia. Animal model experiments and proof-of-concept studies suggest that the incretins favorably affect the cardiovascular system; it is possible that these same effects may be conveyed by DPP-4 inhibitor therapy. Pooled and meta-analyses of DPP-4 inhibitor clinical trial data have shown no increase in major adverse cardiovascular events, and, in fact, suggest a potential cardiovascular benefit to such therapy. Long-term cardiovascular safety trials are currently underway to more fully define and understand the cardiovascular impact of DPP-4 therapy in patients with type 2 diabetes mellitus.

Duke Scholars

Published In

Postgrad Med

DOI

EISSN

1941-9260

Publication Date

July 2012

Volume

124

Issue

4

Start / End Page

54 / 61

Location

England

Related Subject Headings

  • Meta-Analysis as Topic
  • Incretins
  • Humans
  • General & Internal Medicine
  • Dipeptidyl-Peptidase IV Inhibitors
  • Diabetes Mellitus, Type 2
  • Cardiovascular System
  • Cardiovascular Diseases
  • Blood Glucose
  • 4203 Health services and systems
 

Citation

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Green, J. B. (2012). The dipeptidyl peptidase-4 inhibitors in type 2 diabetes mellitus: cardiovascular safety. Postgrad Med, 124(4), 54–61. https://doi.org/10.3810/pgm.2012.07.2566
Green, Jennifer B. “The dipeptidyl peptidase-4 inhibitors in type 2 diabetes mellitus: cardiovascular safety.Postgrad Med 124, no. 4 (July 2012): 54–61. https://doi.org/10.3810/pgm.2012.07.2566.
Green, Jennifer B. “The dipeptidyl peptidase-4 inhibitors in type 2 diabetes mellitus: cardiovascular safety.Postgrad Med, vol. 124, no. 4, July 2012, pp. 54–61. Pubmed, doi:10.3810/pgm.2012.07.2566.

Published In

Postgrad Med

DOI

EISSN

1941-9260

Publication Date

July 2012

Volume

124

Issue

4

Start / End Page

54 / 61

Location

England

Related Subject Headings

  • Meta-Analysis as Topic
  • Incretins
  • Humans
  • General & Internal Medicine
  • Dipeptidyl-Peptidase IV Inhibitors
  • Diabetes Mellitus, Type 2
  • Cardiovascular System
  • Cardiovascular Diseases
  • Blood Glucose
  • 4203 Health services and systems