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The prolonged activity of incretin hormones produces two key effects that help lower blood glucose levels: Increased insulin secretion from the pancreatic beta cells in response to meals Reduced glucagon release from pancreatic alpha cells, which limits unnecessary glucose production by the liver Because these effects are glucose-dependent meaning they are most pronounced when blood sugar is already elevated DPP-4 inhibitors carry a relatively low risk of hypoglycaemia when used alone or with metformin

Indeed, several distinct stimuli, each with different receptors and mechanisms of action, have been found to induce the neutrophil respiratory burst and pentose cycling ex vivo (8)

As more manufacturers enter the field, post-marketing surveillance will play a larger role in identifying rare adverse effects or formulation differences

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