Dipeptidyl Peptidase-4 inhibitor

Examples: Sitagliptin, saxagliptin, linegliptin

Effect:

• 1-2% reduction in A1C → raise endogenous GLP-1 and GIP
• Prevent the break down of GLP-1RA and Tirzepatide (GIP/GLP-1 RA)
• Reserved for end stage renal failure

Conditions:

• T2DM

Side effects:

• GI side-effects
• !Acute Pancreatitis (rare)
• !SJS/TEN (rare)

Contraindication:

• HF - Heart Failure (Saxagliptin)

MOA:

• Prevent Incretin break down
• GIP/GLP-1: induce insulin release in blood glucose-dependent manner → only work when BG is high
  • Better than Sulphonylureas (”G…ide”) in risk of hypoglycaemia