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Table 1 Comparison of GLP-1R agonists and DPP-4 inhibitors.

From: Differentiating among incretin-based therapies in the management of patients with type 2 diabetes mellitus

  GLP-1R Agonists DPP-4 Inhibitors
Agents currently available in U.S. with dosing information (normal renal function)[3135] • Exenatide 5-10 mcg SC BID • Liraglutide 1.2-1.8 mg QD • Sitagliptin 100 mg PO QD • Saxagliptin 2.5-5 mg PO QD • Linagliptin 5 mg PO QD
Benefits
Reduction in A1C level*[2224, 26, 29, 3645] 0.5%-1.5% 0.5%-0.9%
Reduction in fasting plasma glucose*[29, 3941, 4951] ↓7 to 74 mg/dL ↓11 to 29 mg/dL
Reduction in postprandial glucose*[9, 27, 51, 54, 55] ↓41 to 47 mg/dL ↓49 to 68 mg/dL
Weight effect [14, 22, 24, 26, 29, 37, 3941, 44, 45, 49, 50, 52, 60] ↓1-4 kg ↓0.9 to ↑1.4 kg
Effect on triglycerides [24, 29, 36, 37, 39, 41, 49, 60, 62] ↓12-40 mg/dL ↑16 mg/dL to ↓35 mg/dL
Reduction in systolic blood pressure [13, 14, 24, 29, 36, 37, 39, 41, 49, 60, 62] ↓1-7 mm Hg 0 to ↓3.9 mm Hg
May improve markers of pancreatic β-cell function (such as homeostasis model assessment-β-cell function, fasting insulin, fasting proinsulin to insulin ratio, fasting C-peptide)[8, 13, 2224, 26, 30]
Disadvantages
Incidence of mild/moderate hypoglycemia**[9, 10, 24, 26, 3639, 41, 4345, 52, 55, 64] 0%-12% 0%-4%
Nausea [13, 3335] 26%-28% 0-1%
Hypersensitivity reactions [3335] Rare (exenatide)
Antibody formation [3135, 79, 80] 30-67% E; 8% L NR
  1. *As monotherapy or as add-on therapy.
  2. **Generally included asymptomatic hypoglycemia or symptomatic hypoglycemia with blood glucose < 55 mg/dL not requiring third-party assistance.
  3. BID, twice daily; NR, not reported; PO, orally; QD, once daily; SC, subcutaneously