DPP-4 Inhibitors in the Management of Diabetes: Exploring Molecular Insights and Clinical Significance

Abstract

Diabetes is a metabolic illness that affect millions of people worldwide. The current therapy used in the treatment of diabetes leads to various adverse effect such as improper dosing schedule, low potency, ineffective targeting, reduced metabolism and weight gain. Therefore, there is the great need of antidiabetic drugs which helps to reduce the suffering of patients. Dipeptidyl peptidase 4 (DPP-4) has emerged as highly a powerful therapeutic treatment option for the management of type-2 diabetes mellitus (T2DM). The DPP-4 inhibitors works at a molecular level by blocking the enzymatic activity of DPP-4 that increases the half-life of endogenous incretin hormones that includes glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This leads to enhanced glucose-dependent insulin secretion, suppression of glucagon secretion, delayed gastric emptying and ultimately improved glycemic control. In clinical trials, DPP-4 inhibitors have demonstrated efficacy as monotherapy or in combination with other anti-diabetic drugs, like metformin, sulfonylureas etc. Various clinical trials have highlighted their ability to reduce hemoglobinA1c (HbA1c) level, fasting plasma glucose and post-prandial hyperglycaemic excursions, they also give benefits on weight neutrality and low risk of hypoglyceamia. This review provides a comprehensive overview of the molecular mechanisms and clinical implications of DPP-4 inhibitors in diabetes management. In addition, DPP-4 inhibitors represent a valuable therapeutic option for the management of T2DM.