Type 2 diabetes mellitus (T2DM), the most prevalent form, is
characterised by insulin insensitivity as a result of insulin resistance,
declining insulin production, and eventual pancreatic beta-cell failure.
Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new class of Oral Hypoglycemic
Drugs (OHD) that can control T2DM. This chapter aims to provide a critical and
systematic update of the specialised literature on the therapeutic effects and
safety profile of hypoglycemic drugs, used in combination with DPP-4
inhibitors, in the management of type 2 diabetes mellitus. Given the rapid
advances in the field of medicine and the pharmaceutical industry, therapeutic
strategies for this pathology have undergone significant changes, oriented not
only towards effective glycemic control but also towards reducing
cardiovascular risks and mortality associated with the disease. Numerous
studies have investigated the impact of different therapeutic combinations on
the evolution of patients with type 2 diabetes mellitus, paying particular
attention to the associations between metformin and other classes of
hypoglycemic drugs. An important part of the research has focused on comparing
the classic metformin–sulfonylurea combination with more recent therapeutic
regimens, such as metformin associated with DPP-4 inhibitors. The data suggest
that the use of sulfonylureas combined with metformin is associated with a
significantly increased risk of severe hypoglycemia compared with
metformin–DPP-4 inhibitors. Another relevant observation is related to the use
of insulin in combination with metformin. According to the analysed data, this
therapeutic combination was associated with a higher risk of all-cause
mortality, compared with treatment based on DPP-4 inhibitors combined with
metformin. In conclusion, the current evidence supports the use of DPP-4 inhibitors
in combination with metformin as a safer therapeutic alternative to
sulfonylureas or insulin, especially in terms of reducing the risk of severe
hypoglycemia, cardiovascular events and mortality. These results highlight the
need to integrate recent clinical data into medical practice guidelines and to
individualise the treatment for patients with type 2 diabetes.
Author(s) Details
Nina Filip
Department of Morpho Functional Sciences II, Biochemistry, Faculty of
Medicine, Grigore T. Popa University
of Medicine and Pharmacy Iasi, Romania.
Cristina Elena Iancu
Department of Biochemistry, Faculty of Pharmacy, Grigore T. Popa University
of Medicine and Pharmacy Iasi, Romania.
Diana Zamosteanu
Department of Morpho Functional Sciences I, Pathology, Faculty of Medicine,
Grigore T. Popa University of
Medicine and Pharmacy Iasi, Romania.
Cristiana Filip
Department of Morpho Functional Sciences II, Biochemistry, Faculty of
Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.
Magdalena Birsan
Department of Drug Industry and Pharmaceutical Biotechnology, Faculty of
Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.
Madalina Mocanu
Department of Dermatology, Grigore T. Popa University of Medicine and
Pharmacy Iasi, Romania.
Please see the book here :- https://doi.org/10.9734/bpi/psnid/v10/7009
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