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Indications: Type 2 Diabetes Mellitus (monotherapy or add-on therapy) Especially useful in patients who cannot tolerate metformin or sulfonylureas Can be used in elderly and patients with mild renal impairment Approved Agents in India: Sitagliptin (Januvia) Vildagliptin (Galvus) Saxagliptin (Onglyza) Linagliptin (Trajenta) No renal dose adjustment needed Alogliptin (Nesina) Dosing: Once daily oral dosing Some agents require renal dose adjustment (except Linagliptin) Often combined with metformin or SGLT2 inhibitors Side Effects: Nasopharyngitis, headache GI upset (mild) Rare: Acute pancreatitis, severe joint pain, skin reactions Saxagliptin may slightly increase risk of heart failure in some patients Advantages Over Other Classes: Weight neutral Low risk of hypoglycemia Well tolerated in the elderly Convenient once-daily dosing Limitations: Modest HbA1c reduction (0.50.8%) Not effective in Type 1 Diabetes Less potent than GLP-1 analogs or SGLT2 inhibitors Conclusion: DPP-4 inhibitors are a safe, effective, and well-tolerated option for many patients with T2DM especially those needing an add-on to metformin or who can't tolerate injectables

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Pharmacist Formulated, Recommended by top Endocrinologist Experts These statements have not been evaluated by the Food and Drug Administration

Secondary outcomes included time below and above the therapeutic range and INR variability