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DPP-4 inhibitor mechanism — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsDPP-4 inhibitor mechanismGPhC CRA

A 44-year-old man with type 2 diabetes attends the pharmacy. He is currently taking metformin 1 g twice daily and his HbA1c is 62 mmol/mol. His GP has added sitagliptin 100 mg once daily. He asks how sitagliptin works. What is the most appropriate explanation?

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Reveal the answer and explanation

Correct answer: E — Sitagliptin increases the release of insulin from the pancreas by enhancing the effect of incretin hormones

Sitagliptin is a DPP-4 inhibitor (gliptin) that works by preventing the breakdown of incretin hormones (GLP-1 and GIP), which stimulate insulin secretion and suppress glucagon release in a glucose-dependent manner. This means it carries a low risk of hypoglycaemia. It does not block sugar absorption (acarbose), increase insulin sensitivity (pioglitazone), block renal glucose reabsorption (SGLT2 inhibitors), or significantly slow gastric emptying (GLP-1 agonists).

Reference: BNF; NICE NG28 Type 2 Diabetes