DPP-4 inhibitors (also Gliptins called) are oral antidiabetics used to treat type 2 diabetes. They prolong the effect of the body's own intestinal hormones GLP-1 and GIP by inhibiting the degrading enzyme DPP-4. The blood sugar reduction occurs glucose-dependently and without any relevant risk of hypoglycemia.
Mode of action
After a meal, the intestine releases incretins (GLP-1 and GIP), which stimulate insulin release and inhibit glucagon secretion. The enzyme DPP-4 quickly breaks down these hormones. DPP-4 inhibitors block this enzyme, allowing incretins to remain active longer.
Advantages
- Very low risk of hypoglycemia with monotherapy
- Weight-neutral (neither increase nor decrease)
- Good tolerance and easy to take (tablet)
- Can be easily combined with metformin, SGLT2 inhibitors or insulin
Important active ingredients and preparations (as of 2026)
| active ingredient | Brand names | Typical dosage |
|---|---|---|
| Sitagliptin | Januvia, Xelevia | 100 mg once daily |
| Linagliptin | Trajenta | 5 mg once daily (no dose adjustment in case of renal insufficiency) |
| Saxagliptin | Onlyza | 2.5-5 mg once daily |
| Vildagliptin | Galvus | 50 mg 1-2 times daily |
Side effects and special features
The preparations are well tolerated. Headaches or upper respiratory tract infections rarely occur. A very rare risk of pancreatitis is discussed. Linagliptin is particularly suitable for impaired kidney function as it is predominantly excreted in the bile.
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
→ Type 2 diabetes
Sources
- German Diabetes Society (DDG). S3 guideline “Type 2 diabetes”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025. Available at: diabetesatlas.org.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
