Table 2.
Pharmacodynamics: GLP-1 agonists versus DPP-4 inhibitors
| GLP-1 agonists | DPP-4 inhibitors | |
|---|---|---|
| Plasma GLP-1 concentrations | Pharmacological concentrations of the GLP-1 analogue (sixfold to tenfold greater than endogenous GLP-1) | Twofold to threefold increase |
| Glucose-dependent insulin secretion | Yes | Yes |
| Glucose-dependent inhibition of glucagon secretion | Yes | Yes |
| HbA1c reduction (%) | 0.8 to 1.8 | 0.5 to 1.1 |
| Inhibition of gastric emptying | Short acting only | No |
| Postprandial glucose reduction | Yes: short acting > long acting | Yes (weaker) |
| Fasting plasma glucose reduction | Yes: long acting > short acting | Yes (weaker) |
| Effects on weight | Significant weight loss | Weight neutral |
| Inhibition of food intake | Yes | No |
| Gastrointestinal adverse effects: nausea, vomiting and diarrhoea | Common | Uncommon |
DPP-4 dipeptidyl-peptidase-4, GLP glucagon-like peptide, HbA 1c glycated haemoglobin.