[Use of dipeptidyl peptidase-4 inhibitors in patients with diabetes]

New drugs have been added to the treatment of type 2 diabetes mellitus. These drugs have represented an advance in the physiopathological approach to the disease, with the possibility of acting on the different mechanisms involved in raised blood glucose levels and allowing treatment to be individualised, as recommended in clinical practice guide-lines and consensus documents. The incretins were added to the therapeutic arsenal of diabetes in 2006. This group in-cludes glucagon-like peptide-1 receptor antagonists and dipeptidyl peptidase-4 inhibitors (marketed in Spain in 2007), which act on the incretin system in the gut, reducing glycae-mia, with a decreasing or neutral effect on weight and with a low risk of hypoglycaemic episodes. Their introduction coincided with the publication of the controversial results of studies on intensive glycemic control, leading the Food and Drug Administration (2008) to require demonstration of the cardiovascular safety of new glucose-lowering drugs. The publication of subsequent studies has demonstrated cardiovascular safety and some have shown cardiovascular and survival benefits. These results are modifying the recommenda-tions of the clinical practice guidelines and consensus documents on the treatment of type 2 diabetes. The present article describes the main pharmacological and cardiovascular characteristics of the safety and tolerability of dipeptidyl peptidase-4 inhibitors, which need to be known and updated in primary care, given their wide prescription and the need for correct use of drug therapy in type 2 diabetes.