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DPP-4 Therapy Center

TECOS Trial: No CVD Risks or Heart Failure with Sitagliptin in High-Risk Diabetic Patients

No significant difference in incidence of infections, cancer, renal failure, or severe hypoglycemia… In patients with type 2 diabetes and cardiovascular disease, the use of sitagliptin (Januvia, Merck), a dipeptidyl peptidase-4 (DPP-4) inhibitor used to lower HbA1c levels, is not associated with an increased risk of cardiovascular events, according to …

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Practical Diabetes Care, 3rd Ed., Excerpt #9: Pharmacological Treatment of Hyperglycemia Part 2 of 2

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David Levy, MD, FRCP Drugs acting on the incretin system (entero-insular axis) (Fig. 6.2) The incretin effect Bayliss and Starling inferred the existence of gut-derived substances affecting carbohydrate metabolism more than a century ago, but the incretin effect was not described until 1969: the observation that for a given achieved level …

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Practical Diabetes Care, 3rd Ed., Excerpt #8: Pharmacological Treatment of Hyperglycemia Part 1 of 2

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David Levy, MD, FRCP Introduction The pharmacological management of blood glucose in type 2 diabetes remains the most contentious area of diabetes management, and although until relatively recently in the USA the only agents to treat blood glucose were insulin and sulphonylureas, this limited repertoire in no way inhibited the controversy, …

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Practical Diabetes Care, 3rd Ed., Excerpt #7: Type 2 Diabetes: General Introduction Part 2 of 2

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David Levy, MD, FRCP General Recommendations on Macronutrients Carbohydrate Recommended daily allowance is about 130 g. Low glycemic index foods (e.g. barley, oats, beans, lentils, rye bread) can reduce HbA1c by about 0.4% (4 mmol/mol) compared with high glycemic index foods. More importantly, high whole-grain, cereal fiber, bran and germ intake …

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