EFFICACY AND SAFETY PROFILE OF DPP-4 INHIBITORS AS ADD-ON THERAPY IN PATIENTS WITH TYPE 2 DIABETES: A COMPREHENSIVE REVIEW

Aim: This study aimed to evaluate the efficacy and safety profile of DPP-4 inhibitors as add-on therapy in patients with type 2 diabetes. The study is important because DPP-4 inhibitors have been widely prescribed, and understanding their comprehensive effects is essential for better patient outcomes. Methods: An extensive literature search has been conducted using multiple databases, such as PubMed, Cochrane Library, Scopus, Web of Science, and Google Scholar. All results have been analyzed based on inclusion and exclusion criteria, and their findings are displayed statistically to ensure accurate comparisons between treatment groups. Results: DPP-4 inhibitors demonstrate significant efficacy in managing type 2 diabetes mellitus (T2DM), leading to a reduction in glycated hemoglobin (HbA1c) levels by 0.9% (9 mmol/mol; p < 0.0001) and fasting blood glucose (FBG) by 1.15 mmol/L (19.82 mg/dL; p = 0.001) among a cohort of 105 individuals. Notably, sitagliptin exhibited a remarkable HbA1c reduction of 1.66% (19 mmol/mol; p < 0.0001). These inhibitors also significantly curtailed glycemic variability, as evidenced by a mean amplitude of glycemic excursions (MAGE) reduction of -14.61 (95% CI = -19.00 to -10.21; p < 0.0001). Although linagliptin showed a non-significant weight increase of 0.2 ± 0.2 kg (P = 0.349), the overall cardiovascular benefits of DPP-4 inhibitors are noteworthy, with a 31% reduction in the risk of cardiovascular mortality or heart failure rehospitalization (HR: 0.69; P = 0.002). The renal protective effects include alleviation of albuminuria and slowing of chronic kidney disease progression. Common adverse reactions include nasopharyngitis and gastrointestinal disturbances, while serious adverse effects, such as pancreatitis and severe dermatological reactions, warrant close monitoring and caution.