Incretin-based therapy: how do incretin mimetics and DPP-4 inhibitors fit into treatment algorithms for type 2 diabetic patients?

Best Pract Res Clin Endocrinol Metab. 2009 Aug;23(4):513-23. doi: 10.1016/j.beem.2009.03.002.

Abstract

Incretin-based antidiabetic medications have been approved for clinical use for approximately two to three years. While their major clinical characteristics have been known from clinical trials, the discussion now focuses on the best clinical use of GLP-1 receptor agonists (incretin mimetics) and inhibitors of the protease dipeptidyl peptidase-4 (DPP-4). Any novel drug will not fully disclose its spectrum of beneficial and adverse activity before long-term trials with clinical endpoints are available. This, typically, will last 5-8 years. Nevertheless, there are convincing reasons to use incretin mimetics and DPP-4 inhibitors even in the absence of such results. This decision should be based on specific patient characteristics and (expected) treatment results, in comparison to other available treatment options. The present manuscript tries to describe the current state-of-the-art of using incretin mimetics and DPP-4 inhibitors in clinical practice, including an attempt to suggest their place in treatment algorithms for type 2-diabetic patients.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Animals
  • Biomimetics
  • Cardiovascular System / drug effects
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Incretins / economics
  • Incretins / therapeutic use*
  • Insulin-Secreting Cells / drug effects

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • Incretins