Targets and modern strategy of therapy for different groups of patients with type 2 diabetes mellitus
Dipeptidyl peptidase-4 (DPP-4) inhibitors is one of the most promising groups of hypoglycemic drugs (HGDs) used for the treatment of type 2 diabetes mellitus. In recent years, DPP-4 inhibitors have become widespread due to a unique mechanism of action, high efficiency and safety, availability and ease of use. One of the most promising combinations of HGDs is the combination of DPP-4 inhibitors with metformin, which affects virtually all stages of progression of type 2 diabetes mellitus. First of all, it concerns such a DPP-4 inhibitor as vildagliptin (Galvus), which together with metformin is a part of the fixed combination Galvus Met. The selective and reversible inhibition of the DPP-4 enzyme against the background of therapy with vildagliptin results in an increase in the half-life of the endogenously secreted glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1, increasing the possibility of glucose-dependent insulin secretion by ß cells and exerting pleiotropic extra-pancreatic effects, and metformin remains the drug of choice for correction insulin resistance.