Januvia and Vildagliptin for T2 Diabetes not in control

Januvia (Merck)
http://www.endocrinetoday.com/200611...rticle=fda.asp
FDA approves DPP-IV inhibitor sitagliptin for type 2 diabetes
November 2006

The FDA has approved sitagliptin (Januvia) , a dipeptidyl peptidase-IV
inhibitor, for the treatment of type 2 diabetes.Sitagliptin was approved as
monotherapy and as an adjunct to metformin or thiazolidinediones to improve
glucose control in patients with type 2 diabetes when diet and exercise is
not sufficient.Sitagliptin (Januvia, Merck) is the first DPP-IV inhibitor to
be approved. The agent's mechanism of action is glucose-dependent; it
responds to the presence of elevated glucose. By inhibiting the DPP-IV
enzyme, sitagliptin significantly increases the levels of active incretin
hormones, increasing the synthesis and release of insulin from the
pancreatic beta-cells and decreasing the release of glucagon from the
pancreatic alpha-cells, according to a Merck press release.

"Those patients who are unable to adequately manage their type 2 diabetes
with lifestyle changes, like healthy eating and increased physical exercise,
and who require medications now have a new product to help regulate their
blood glucose levels," said Edward S. Horton, MD, director of clinical
research at the Joslin Diabetes Center and professor of medicine at the
Harvard Medical School in Boston.



Vildagliptin (Novartis)
http://www.endocrinetoday.com/200611...le=glucose.asp
Vildagliptin suppresses glucose production following meal
November 2006

A recent study has found that a single dose of the DPP-IV inhibitor
vildagliptin caused a significant suppression of endogenous glucose
production in patients with type 2 diabetes.Previous research has indicated
that the therapeutic effects of DPP-IV inhibitors are related mostly to
their effect on glucagon-like peptide 1 and glucose-dependent insulinotropic
peptide, and how this in turn effects insulin secretion. "However, there are
a number of observations that suggest that factors other than change in
insulin levels may be important," said Ralph A. DeFronzo, MD, chief of the
diabetes division at the University of Texas Health Science Center at San
Antonio. "We also know that the effects of these drugs can be seen in the
absence of a meal. Clearly there is a lot more that we need to learn about
how these drugs work."

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