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The burden of diabetic patients on healthcare has increased over the period of time. Management of
diabetes presents a challenge to the physician. The availability of newer drugs, tested in high quality
clinical trials, has marked a new era in the treatment of diabetes. Glucagon-like peptide 1 (GLP-1)
analogs act by increasing the pancreatic beta-cell mass and subsequent insulin secretion. Dipeptidase-4
(DPP-4) inhibitors inhibit the enzyme that degrades GLP-1, resulting in the augmentation of GLP-1 in the
body. Hence, the two drugs can be used synergistically. It was seen that severe hypoglycemia seldom
occurred with GLP-1 analogues and DPP-4 inhibitors. Gastrointestinal upset and the development of
antibodies to the drug in the body was mainly attributed to GLP-1 analogs. DPP-4 inhibitors showed
increased risk of nasopharyngitis, urinary tract infections and headache.
There is a need for further advances in our understanding, through randomized control clinical trials in
larger settings, to establish the role and safety of these newer agents in the treatment of diabetes. The
initiation of a modern set of medications may help us control type2 diabetes better.
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