According to a recent report in Journal of American Medical Directors. Association, The family of drugs, called dipeptidyl peptidase-4 or DPP-4i inhibitors, is associated with a lower risk of heart attack and stroke in the elderly. Researchers at Yang-Min National University and various research institutions in Taipei, Taiwan, found similar results.
The researchers compared participants with a diagnosis of type 2 diabetes aged 65 and over, their medications, and the risk of heart and blood vessel disease. A total of 58,485 patients with type 2 diabetes who received treatment with DPP-4 drugs were compared with diabetic participants using other means of controlling blood sugar. It was found that among participants using DPP-4i, the risk of developing a heart attack and stroke is 21 percent less.
DPP-4i preparations, also known as incretin mimetics, include ...
- sitagliptin (Januvia)
- linagliptin (Tradjenta)
- vildagliptin (Galvus, Zomelis)
- vildagliptin and metformin (Eucreas)
- saxagliptin (Onglyza)
- saxagliptin and metformin (Kommoliz)
- sitagliptin and metformin (Janumet)
- alogliptin (Vipidia)
- alogliptin and metformin (Vipdomet)
- linagliptin (Trajenta)
- linagliptin and metformin (Jentaduet)
The above medications are not usually used as a first line defense unless there is no reason not to start with metformin. Metformin is the first drug of choice, then other drugs are added.
DPP-4i preparations work by blocking the DPP-4 enzyme. DPP-4 destroys the hormone incretin, which helps the body make insulin. Because of their similarity to incretin, DPP-4 inhibitors join DPP-4, allowing incretin to remain free and able to do its job of insulin relief. Incretins also reduce the amount of sugar produced by the liver when sugar is not needed for energy. They are released throughout the day, with higher levels released after eating.
One of the most easily understood incretins is GLP-1, which is released from the small intestine when it feeds there. GLP-1 works in three ways ...
1. GLP-1 helps the pancreatic beta cells release insulin when blood sugar rises.
2 It slows down the emptying of the stomach, so food is not digested and absorbed too quickly and
3 It reduces the amount of glucagon, a hormone released from the alpha cells of the pancreas and increases blood sugar levels.
GLP-1 also attaches to adipose tissue, brain, and heart. Can DPP-4 inhibitors with their similarity to GLP-1 also bind to the brain and heart in an effort to prevent strokes and heart attacks in the elderly? It takes extra work to find the answers.
