Incretin mimetics and dipeptidyl peptidase 4 inhibitors in clinical trials for the treatment of type 2 diabetes

Exenatide is associated with a reduction in average hemoglobin A1c (HbA1c) levels of approximately 0.8% compared with baseline.

• Sitagliptin and vildagliptin lead to a reduction in HbA1c levels of about 0.7%.
• The actions of incretin-based drugs mainly focus on reducing high blood sugar levels after meals.
• Mild treatment-related hypoglycemia occurs primarily when these drugs are used with sulfonylureas.
• Exenatide treatment results in a mild weight loss of around 2 kg after 30 weeks, while sitagliptin and vildagliptin have a generally neutral effect on weight.
• Sitagliptin and vildagliptin are well tolerated in trials lasting up to 52 weeks, whereas 5-10% of patients may not tolerate exenatide due to nausea and vomiting.
• There is a lack of long-term safety and efficacy data for all three medications.

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