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However, the introduction of GLP-1, a key incretin hormone, has revolutionized the treatment of obesity and T2D

[DOI] [PMC free article] [PubMed] [Google Scholar] 57.McLean BA, et al

Shuster A et al, The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis

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GLP-1 medications are peptides, and peptides are fragile biological molecules that start degrading the moment they leave controlled storage conditions

Inhibitors of DPP-4, such as sitagliptin, vildagliptin and linagliptin, inhibit DPP-4, resulting in an increase of incretin and GLP-1 secretion (Figure 1), leading to an improvement in plasma glucose control without inducing hypoglycemia or increasing the body weight.69 Both types of drugs are barely metabolized in the liver and are excreted unchanged by the kidney;70 thus, they seem to be safe in cirrhotic patients.71 Unlike the old antidiabetic drugs, their pharmacodynamic characteristics have been assessed in patients with varying degrees of hepatic impairment and their safety has been assessed in studies comprising large number of individuals