All are true about sitagliptin EXCEPT:
Always given with insulin
Preferentially reduce post prandial blood sugar
Less side effects
Lowers HbA1 C
ANSWER: (A) Always given with insulinREF: Harrison's 18th ed ch: 344Dipeptidyl peptidase IV inhibitors:Saxagliptin, Sitagliptin, VildagliptinDPP-IV inhibitors inhibit degradation of native GLP-1 and thus enhance the incretin effect. DPP-IV, which is widely expressed on the cell surface of endothelial cells and some lymphocytes, degrades a wide range of peptides (not GLP-1 specific).DPP-IV inhibitors promote insulin secretion in the absence of hypoglycemia or weight gain, and appear to have a preferential effect on postprandial blood glucose.DPP-IV inhibitors are used either alone or in combination with other oral agents in adults with type 2 DM.Reduced doses should be given to patients with renal insufficiency. These agents have relatively few side effects.Reduction in HbA1 C: 0.5-0.8 %Do not cause hypoglycaemiaReduce dose with renal diseaseThe DPP-4 enzyme is known to be involved in the suppression of certain malignancies, particularly in limiting the tissue invasion of these tumours.
Endocrinology