TABLE 3.

Comparison of DPP-4 inhibitor with various classes of antidiabetic agents.

Class of anti-diabetic agents	Action mechanism	Change in body weight	HbA1c reduction (%)	Risk of hypoglycaemia	Microvascular and macrovascular events
DPP-4 Inhibitors	Inhibits DPP-4 enzyme action; elevates postprandial incretin concentration	Weight neutral (−0.09 to +1.11 kg) Lozano-Ortega et al. (2016)	0.5–0.8	Low	Neutral for cardiovascular events; might cause congestive heart failure by degradation of B-type natriuretic peptide
Insulin	Activates receptors of insulin and triggers downstream signaling in various sensitive tissues	Weight gain (+1.56 to +5.75 kg) Giugliano et al. (2011)	1–2.5	Evident	Might lead to heart failure when associated with thiazolidinedione
Metformin	Insulin sensitizer; various impacts on suppression of hepatic glucose production	Change in body weight (+1.5 to −2.9 kg) Golay (2008)	1–2	No	Lowers coronary deaths by 50% and myocardial infarction by 39%
Thiazolidinedione	True insulin sensitizer; activate nuclear transcription factor PPAR-γ	Weight gain (+2.30 to +4.25 kg) Lozano-Ortega et al. (2016)	0.5–1.4	Low	Pedal edema, cardiac failure
Sulphonylureas	Elevates insulin secretion; closes KATP channels on plasma membrane of β-cell	Weight gain (+1.99 to +2.31 kg) Hirst et al. (2013)	1–2	Evident	Elevated cardiovascular risk factors, majorly because of hypoglycaemia
GLP-1 Analogues	Activates receptors of GLP-1; elevation in insulin secretion, suppression in glucagon secretion, and gastric emptying is delayed	Reduction in body weight (−1.14 to −6.9 kg) Trujillo et al. (2015)	0.5–1.5	No	Lowers cardiovascular risk
SGLT-2 Inhibitors	Insulin-independent mechanism of action; glucosuria because of inhibition of reabsorption of glucose in renal proximal tube	Reduction in body weight (−0.9 to −2.5 kg) Storgaard et al. (2016)	0.5–0.9	Low	Positive cardiovascular impact because of lowering of uric acid and sodium absorption, and decrease of blood pressure