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DPP-4 inhibitors in current diabetes care: their foundational role in treating to target

Angelo Avogaro1, Enrico Fiaccadori2, Maria Rosaria Rizzo3

  • 1University of Padova, Padova, Italy.

Diabetes Research and Clinical Practice
|May 3, 2026
PubMed

Insights

Dipeptidyl peptidase-4 inhibitors (DPP-4is) help type 2 diabetes patients reach blood sugar goals safely. They offer benefits for both glycemic control and cardiovascular-kidney protection.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Cardiology

Background:

  • Many type 2 diabetes patients fail to meet glycemic targets, increasing complication risks.
  • Current guidelines balance glycemic control (treat-to-target) with organ protection (treat-to-benefit).

Purpose of the Study:

  • To review the role of dipeptidyl peptidase-4 inhibitors (DPP-4is) in an integrated diabetes management framework.
  • To evaluate DPP-4is for achieving glycemic targets while considering cardiovascular and renal benefits.

Main Methods:

  • Review of clinical guidelines and cardiovascular outcome trial data for DPP-4is.
  • Analysis of DPP-4is efficacy, safety, and tolerability profiles.

Main Results:

  • DPP-4is achieve HbA1c reductions of 0.6-1.1% with low hypoglycemia risk and weight neutrality.
  • DPP-4is are cardiovascularly safe and suitable for combination therapy, aiding glycemic intensification.
  • Favorable tolerability makes DPP-4is ideal for older patients.

Conclusions:

  • DPP-4is effectively bridge treat-to-target and treat-to-benefit strategies in type 2 diabetes.
  • DPP-4is, especially sitagliptin, support comprehensive cardiovascular-kidney-metabolic risk reduction.
  • DPP-4is offer a versatile option for optimizing diabetes care and patient outcomes.
Keywords:
DPP-4 inhibitorsTreat-to-benefitTreat-to-targetTreatmentType 2 Diabetes

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