Sitagliptin, and its current status in the management of patients with type 2 diabetes mellitus

Czech version

Authors: Vladimír Uličiansky
Published in: Diab Obez 2022; 22(44): 74-84
Category:

Overview

DDP-4 inhibitors increase insulin secretion and reduce glucagon secretion by elevating endogenous GLP-1 concentrations in a glucose dependent manner. The first DPP-4 inhibitor that was introduced to the market in the Slovak Republic was sitagliptin. Sitagliptin is administered orally, is well tolerated, has a low risk of hypoglycemia and a neutral effect on body weight. Can be used in impaired renal function. The recommended dose needs to be adjusted based on renal function. In clinical study TECOS among patients with well-controlled type 2 diabetes and cardiovascular disease, sitagliptin had neutral effects on cardiovascular risk, no increase the risk of major adverse cardiovascular events, hospitalization for heart failure or other adverse events. Sitagliptin is good and safe option for the therapy of older patients with type 2 diabetes. Key for success in older, fragile patient is individualization of therapy. Despite concerns regarding a possible increased risk of rare pancreatic adverse events (e.g. pancreatitis) with glucagon-like peptide-1 (GLP-1)-based therapies, such as GLP-1 receptor agonists and DPP-4 inhibitors, no causal association has been found. Sitagliptin can be used alone or in combination with other glucose-lowering agents. DPP-4 inhibitors have a stabile place in therapeutic algorithms of international and national medical associations. Diabetes is a frequent disease with high economical burden. Therefore is necessary to manage diabetic patient rationally. Now sitagliptin is also available in generic form at lower cost.

Keywords:

type 2 diabetes – DDP-4 inhibitors – generics – sitagliptin

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