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The Diabetes Educator, Vol. 33, No. 1, 55-66 (2007)
DOI: 10.1177/0145721706297451
© 2007 American Association of Diabetes Educators; Published by SAGE Publications

PHARMACY UPDATE

The Physiology of Incretin Hormones and the Basis for DPP-4 Inhibitors

Skye Aiko McKennon, BS, PharmD Candidate and R. Keith Campbell, RPh, CDE

From the College of Pharmacy, Washington State University, Pullman.

Correspondence to Skye Aiko McKennon, 775 SE Edge Knoll Drive, Pullman, WA 99163 (skyeko{at}mail.wsu.edu, skyeko{at}gmail.com).

With the rising prevalence of diabetes, new therapies that provide glucose control are needed. Although many medications are available, tight glucose control is still a challenge. In this article, the physiology of glucose homeostasis is explored with respect to type 2 diabetes. The incretin effect is explained in detail, and the incretin hormones, glucose-dependent insulinotrophic polypeptide and glucagon-like peptide 1, are investigated as well as their contribution to type 2 diabetes therapy. Studies involving dipeptidyl-peptidase 4 (DPP-4) inhibitors are summarized as to their effects on glucose homeostasis. Specifically, vildagliptin (Galvus®; Novartis International AG, Basel, Switzerland) and sitagliptin (JanuviaTM; Merck & Co, Inc, Whitehouse Station, NJ) are described. The use and efficacy of the currently available incretin mimetic, exenatide (Byetta®; Amylin Pharmaceuticals, Inc and Eli Lilly and Company, San Diego, Calif, and Indianapolis, Ind), are briefly discussed. Throughout this article, the rationale for the use of DPP-4 inhibitors is presented.


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