The role and place of dipeptidyl peptidase-4 inhibitors in modern approaches to the management of type 2 diabetes mellitus

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Abstract

Type 2 diabetes mellitus (T2 DM) continues to occupy a leading position in terms of the rate of spread worldwide. The focus of treatment of T2 DM has shifted from purely glycemic control to general management of risk factors with the achievement of personalized treatment goals. The modern concept of management of patients with this diagnosis is based on the early appointment of combination therapy aimed at long-term retention of glycemic control. Currently, DPP-4 inhibitors is the most widely represented class of hypoglycemic drugs (HD). The combination of sitagliptin and metformin provides a significant improvement in glycemic control, and slows down the progression of T2 DM. The appearance of generic analogues of new representatives of the DPP-4 inhibitors on the pharmaceutical market allows expanding the possibilities of implementing an early combined approach in the management of T2 DM. The article presents basic information about the importance of the DPP-4 inhibitors class in modern management strategies for patients with T2 DM, the possibilities of this therapy, as well as the advantages of combination therapy in such patients.

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About the authors

Tatyana Yu. Demidova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: t.y.demidova@gmail.com
ORCID iD: 0000-0001-6385-540X

MD, Professor, Head of the Department of Endocrinology of the Faculty of General Medicine

Russian Federation, Moscow

Fatima O. Ushanova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: fati_2526@mail.ru
ORCID iD: 0000-0001-5512-6899

PhD in Medical Sciences, Assistant at the Department of Endocrinology of the Faculty of General Medicine

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig 1. Pancreatic and extrapancreatic effects of incretins in the body

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3. Fig. 2. Dynamics of glycated hemoglobin (HbA1c) level during addition of glimepiride, sitagliptin, liraglutide, and insulin glargine to metformin therapy in the GRADE study (adapted from [26])

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4. Fig. 3. Dynamics of glycated hemoglobin (HbA1c) and glycated albumin levels against sitagliptin therapy (adapted from [27])

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5. Fig 4. Percentage of decrease in glycated hemoglobin (HbA1c) with the combination of sitagliptin and metformin [34]

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