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Aus der chemischen Strukturformel und der Herstellung geht hervor, dass es ein dreifach methyliertes Dipeptid ist es wird aus Aminosuren gebildet, ist jedoch ein Peptid

Pathophysiologic Defects in Type 2 Diabetes Impaired incretin effect Reduced GLP-1 and GIP activity Decreased glucose-dependent insulin secretion Inadequate suppression of glucagon Increased lipolysis and insulin resistance Increased release of free fatty acids Worsening insulin resistance Increased hepatic fat accumulation Impaired peripheral glucose uptake Reduced glucose uptake by skeletal muscle Decreased insulin sensitivity Persistent hyperglycemia Increased renal glucose reabsorption Increased glucose reabsorption by the kidneys Reduced urinary glucose excretion Higher blood glucose levels Neurotransmitter dysfunction Brain insulin resistance Altered appetite regulation Impaired glucose homeostasis Increased hepatic glucose output Increased gluconeogenesis Increased glycogen breakdown Excess glucose production by the liver Increased glucagon secretion Excess glucagon release from pancreatic -cells Increased hepatic glucose production Elevated fasting glucose Defective insulin secretion Progressive -cell dysfunction Reduced insulin production Failure to maintain normal glucose levels Glucose-Lowering Medications and Their Sites of Action Metformin Improves insulin resistance Enhances peripheral glucose uptake Reduces hepatic glucose production SGLT2 Inhibitors Reduce renal glucose reabsorption Increase urinary glucose excretion GLP-1 Receptor Agonists & GIP/GLP-1 Receptor Agonists Improve incretin effect Reduce appetite through central nervous system effects Reduce hepatic glucose production Suppress glucagon secretion Enhance glucose-dependent insulin secretion DPP-4 Inhibitors Enhance endogenous incretin activity Reduce hepatic glucose production Suppress glucagon secretion Improve glucose-dependent insulin secretion Thiazolidinediones (TZDs) Improve insulin sensitivity Increase peripheral glucose uptake Reduce hepatic glucose production Sulfonylureas Stimulate pancreatic -cells Increase insulin secretion Key Takeaways Type 2 diabetes is driven by multiple pathophysiologic abnormalities, not a single defect

Impact on gastric emptying and appetite regulation: The action of DPP-4 inhibitors does not affect the rate of gastric emptying

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