What are diabetes medications SGLT2 and DPP-4 Inhibitors?

John Merendino, MD, reviews diabetes treatment medications, sodium-glucose transporter-2 (SGLT2) inhibitors, and explains how DPP-4 inhibitors provide blood sugar control.

Transcript

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The newest drugs for treating diabetes are the so-called sodium glucose transport inhibitors or SGLT-2

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inhibitors. This is a class of drugs that was introduced in about 2012.

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They're drugs that prevent our bodies from reabsorbing glucose from our urine. So urine is formed a little bit like an assembly line

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in a factory plant. There's a starting material and there's an end product. And at the beginning, the starting material

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is basically blood plasma. And it has glucose in it. Now your body doesn't want you to be losing glucose

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into your urine because that's your main source of fuel. So as the urine's processed, the glucose is reabsorbed back into the body.

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These drugs interfere with that reabsorption process. And that allows the glucose to pass out into the urine,

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lowering the blood sugar and helping also to perhaps protect against kidney disease with diabetes.

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Invokana, Farciga, and Jardiance are the most widely prescribed

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drugs in the United States. DPP-4 inhibitors are a class of drugs that are used to treat diabetes.

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DPP-4 stands for dipeptidyl peptidase type 4. There are hormones in the pancreas that

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modulate the amount of insulin that's made by the body in response to a high sugar and also modulate the amount of another hormone that's made

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called glucagon. These hormones are made and released and are removed from the body very,

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very quickly because this DPP-4 chemical breaks them down. DPP-4 inhibitors prevent the breakdown of these hormones.

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The levels of the hormones are higher for a longer period of time. Therefore, the body's insulin production is greater.

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And the amount of glucagon produced is less. And glucagon raise the sugar. So together, with more insulin and less glucagon,