BACKGROUND: Mounting evidence indicates that Type 2 diabetes mellitus (T2DM) is a public health challenge globally, and its occurrence is anticipated to surge in the forthcoming years. Dipeptidyl peptidase-4 (DPP-4) serves as a target for its treatment, with its inhibitors effectively preserving the levels of glucose-dependent insulinotropic peptide and glucagon-like peptide 1(GLP-1). This review presents an overview of the therapeutic possibilities of six frequently employed DPP-4 inhibitors (DPP-4is) (Sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin and teneligliptin) in managing T2DM, focussing on their characteristics, mechanism of action, advantages and side effects in comparison with alternative oral antidiabetic drugs as well as the possibility of using in silico method in advancing its timely and cost-effective production.
METHODS: A literature search was conducted using the major search engines such as PubMed/Medline, Scopus, and Google Scholar, etc. employing terms like 'Type 2 diabetes mellitus (T2DM), DPP-4 inhibitors, and Dipeptidyl peptidase-4', etc. to identify relevant studies.
RESULTS: Our findings indicate that DPP-4is stimulate secretion of insulin and suppress secretion of glucagon by elevating endogenous GLP-1 concentrations without an intrinsic hypoglycaemia risk. Although these agents share a common mechanism of action, their considerable structural heterogeneity may lead to distinct pharmacological characteristics. Literature shows that DPP-4is have a promising safety profile in comparison with other oral antidiabetic medications, however, certain safety aspects require additional exploration. Different DPP-4is have demonstrated comparable safety and tolerability, whether used alone or in combination with other antidiabetic medications. Besides, it has been shown that in silico method could be employed in development of DPP-4is. Further research is necessary to ascertain whether differences among DPP-4 inhibitors might influence the occurrence of specific adverse effects.
CONCLUSION: DPP-4 inhibitors remain effective and well-tolerated options for managing T2DM.
