Medications: Dipeptidyl peptidase 4 inhibitors

Adding the DPP-4 inhibitor sitagliptin to first-line metformin therapy may delay the need for exogenous insulin among people with type 2 diabetes, researchers report.

Amrit Lamba discusses how the findings of VERIFY may influence how primary care practitioners will approach first-line treatment of people with type 2 diabetes (4:32).

Upfront combination therapy with vildagliptin and metformin is more durable than metformin alone, and appears to have a legacy effect, report the VERIFY investigators.

Oral semaglutide offers greater efficacy for glucose control and weight loss when compared with sitagliptin for people with type 2 diabetes, although with more adverse events at the highest dose, show the PIONEER 3 findings.

Data from clinical practice suggest the possibility of an increased relative risk for cholangiocarcinoma among patients taking incretin-based antidiabetes medications, although the absolute risk remains small.

Dawwas GK, Smith SM, Park H. Cardiovasc Diabetol 2018; 17: 102. doi: 10.1186/s12933-018-0746-4

Deng Z et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0448-7

Nichol AD, Holle MJ, An R. Eur J Clin Nutr 2018. doi: 10.1038/s41430-018-0170-6

Haneda M et al. Diabetes Ther 2018; Advance online publication. doi: 10.1007/s13300-018-0416-2

Adding the dipeptidyl peptidase-4 inhibitor alogliptin to metformin and sulfonylurea treatment may improve glycemic control in patients with type 2 diabetes and high cardiovascular risk, a post-hoc analysis of the EXAMINE trial suggests.

Researchers have detected a possible increased risk for inflammatory bowel disease among users of dipeptidyl peptidase-4 inhibitors.

What do the results of CVOTs mean for practicing clinicians? Medicine Matters contributor, Carol Wysham reviews the latest evidence and guidelines for reducing CV risk in patients with type 2 diabetes.