Fast Five Quiz: Type 2 Diabetes Incretin-Based Therapy

Romesh Khardori, MD, PhD; Anne L. Peters, MD


April 28, 2023

In type 2 diabetes, the impact of weight should be considered when choosing the most appropriate glucose-lowering therapies. GLP-1 RAs are more effective than DPP-4 inhibitors when weight loss or greater reductions in A1c are treatment priorities. GLP-1 RAs are effective at promoting weight loss by reducing appetite and feelings of hunger through inhibition of glucagon secretion and decreasing gastric emptying. Studies have shown that semaglutide and tirzepatide have very high efficacy for weight loss. Both long-acting and short-acting GLP RAs confer a similar weight loss benefit.

DPP-4 inhibitors are considered weight neutral agents.

Combination therapy with GLP-1 RAs and DPP-4 inhibitors is not recommended, as both elevate GLP-1 and GIP plasma concentrations with nonsignificant effects on glycemic control.

Learn more about type 2 diabetes guidelines.


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