title: Clinical use of GLP-1 agonists and DPP4 inhibitors.
abstract: Type 2 diabetes is a growing problem, with 387 million people currently affected, and 592 million by 2035. Whilst diet and exercise are the corner stones of treatment, oral hypoglycaemic agents are often needed to achieve glycaemic control, thereby reducing the chance of long term diabetic complications. Biguanides and sulfonylureas have been the standard tablets used for this disorder, until 2005-7 when glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP4) inhibitors became available. Their major advantage over sulfonylureas is that they are weight lowering or weight neutral, and have a very low incidence of hypoglycaemia. GLP-1 agonists are injectables, whereas the DPP4 inhibitors are administered orally. Both agents are best used in combination with other hypoglycaemic medication, especially metformin and sodium glucose co-transporter 2 (SGLT2) inhibtors. Usage is increasing, being roughly equal to that of sulfonylureas, but less than that of metformin. Side effects appear to be minimal.
authors.affiliation: School of Medical Sciences, Discipline of Physiology, The University of Sydney, Australia; Centre for Genetic Diseases, Monash Institute of Medical Research, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia. Electronic address: bernard.tuch@uni.sydney.edu.au.
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Tuch
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000191:economics / Q000627:therapeutic use*; D052216:Glucagon-Like Peptide 1 / Q000819:agonists*; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D052216:Glucagon-Like Peptide 1
keywords: Dipeptidyl peptidase-4 inhibitors; Exocrine pancreatic disease; Glucagon-like peptide 1; Incretins; Oral hypoglycaemics; Type 2 diabetes