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Dipeptidyl peptidase 4 (DPP-4) inhibitors are a group of antihyperglycemic medications used to manage type 2 diabetes mellitus, which is a significant risk factor for coronary disease, heart failure, stroke, and many other cardiovascular conditions. This activity reviews the various drugs in this group, indications, contraindications, activity, adverse events, and other key elements of DPP-4 inhibitors therapy in the clinical setting. It also elaborates on the essential information needed by any interprofessional team member managing the care of patients with diabetes. Objectives: Identify the mechanism of action of dipeptidyl peptidase 4 (DPP-4) inhibitors. Describe the potential adverse effects of dipeptidyl peptidase 4 (DPP-4) inhibitors. Review the appropriate monitoring of dipeptidyl peptidase 4 (DPP-4) inhibitors. Outline interprofessional team strategies for improving care coordination and communication to advance diabetes management and improve outcomes using DPP-4 inhibitors. Access free multiple choice questions on this topic.

Clinical trials showed no adverse drug reactions using very high doses of saxagliptin, alogliptin, linagliptin. However, high doses of sitagliptin were associated with an 8.0-millisecond mean increase in QTc in controlled clinical trials as labeled by the FDA. In case of overdose, hemodialysis removes approximately 13% of sitagliptin and approximately 23% of saxagliptin but did not affect alogliptin or linagliptin.

An interprofessional team approach is critical in controlling diabetes and its complications. It requires providers (primary care physician, endocrinologist, ophthalmologist, podiatrist), pharmacists, nurse practitioners, dieticians, and diabetes educator nurses to collaborate as an interprofessional team in providing care. Literature indicates that such a collaborative effect can improve diabetic management, lower the risk of chronic disease complications. [Level 5] Health care providers can emphasize the importance of metabolic control and other cardiovascular risk factors, promote healthy lifestyle practices, including physical activity and healthful eating, and explain the benefits of comprehensive team care. Diabetes nurse educators and dieticians provide education to the patient in improving the patient's weight loss and A1c values with ideal diet and nutrition. Pharmacists can collaborate with patients and their physicians to improve clinical measures, lower health care costs, and making sure that the drugs are in an affordable range to the patient by communicating with the patient's insurance companies. Recognizing danger signs of foot and eye problems and referral to an appropriate provider can be done by any team member. Various health care providers can obtain a referral for regular screening. Specialist providers such as podiatrists, ophthalmologists can help reduce lower extremity amputation rates in foot care clinics, prevent blindness, respectively. National Diabetes Education Program (NDEP), a federally sponsored initiative of the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK), is committed to working with public and private partners in preventing or delaying the onset of type 2 diabetes, promoting early diagnosis, improve treatment and outcomes for people with diabetes. It also offers resources to help healthcare professionals implement collaborative, interprofessional diabetes team care in a variety of settings.