The physiological effect exerted by natural incretins (GLP-1 and GIP), gastrointestinal tract hormones that act as regulators of glycaemia increasing insulin secretion and decreasing that of glucagon as a response to carbohydrate intake, has been known for years. However, it is only recently that the development and commercialisation of hypoglycaemic agents that act as incretin enhacers has become possible. Exenatide, a mimetic incretin with biological properties similar to GLP-1, administered as a subcutaneous injection, as well as sitagliptine and vildagliptine, orally administered DPP4 inhibitors, are currently available.
The hypoglycaemic effect on the reduction of glycated hemoglobin (HbA1c), observed with these new drugs, seems moderate, offering potential advantage of the absence of manifestations of hyploglycaemia associated to treatment and its weight reduction or neutral effect. Its use in monotherapy has not been authorised and are being recommended as treatment associated to metformin, sulfonylurea or glitazones in patients with type 2 diabetes mellitus that have not achieved an adequate glycaemic control.