Adding a DPP-4 Inhibitor to Insulin: Does it Increase Hypoglycemia Risk in T2DM Patients?

the MPR take:

For patients with type 2 diabetes, adding a dipeptidyl peptidase-4 (DPP-4) inhibitor to insulin treatment is associated with a moderate effect on HbA1c without an increased risk of hypoglycemia. In a review published in Diabetic Medicine, randomized controlled studies evaluating DDP-4 inhibitors as an add-on therapy to insulin for type 2 diabetes were evaluated and adding a DDP-4 inhibitor led to lowered glucose of approximately 6.6–8.7mmol/mol (0.60–0.80%) from a baseline HbA1c of 67–78mmol/mol (8.3–9.3%). No increase in risk of hypoglycemia was noted in the findings and the DDP-4 inhibitors had no effect on body weight or daily insulin dose. The positive safety profile and HbA1c effect without the increased risk of hypoglycemia support the use of DDP-4 inhibitor with insulin in patients with type 2 diabetes.

Abstract: To review and discuss the results from the clinical controlled trials comparing a dipeptidyl peptidase-4 inhibitor with placebo treatment as add-on to insulin treatment with respect to changes in HbA1c, weight, fasting plasma glucose, risk of hypoglycaemia and safety in patients with Type 2 diabetes.


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