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With brand names like Wegovy, Ozempic, Mounjaro, Zepbound and Trulicity, these drugs have evolved from diabetes treatments to powerful tools for weight management

its effects on cardiovascular outcomes in people with type 2 diabetes, as well as on reducing morbidity and mortality in people with obesity/overweight, remain under investigation

Lifecycle: Annual

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Indications: Type 2 Diabetes Mellitus (monotherapy or add-on therapy) Especially useful in patients who cannot tolerate metformin or sulfonylureas Can be used in elderly and patients with mild renal impairment Approved Agents in India: Sitagliptin (Januvia) Vildagliptin (Galvus) Saxagliptin (Onglyza) Linagliptin (Trajenta) No renal dose adjustment needed Alogliptin (Nesina) Dosing: Once daily oral dosing Some agents require renal dose adjustment (except Linagliptin) Often combined with metformin or SGLT2 inhibitors Side Effects: Nasopharyngitis, headache GI upset (mild) Rare: Acute pancreatitis, severe joint pain, skin reactions Saxagliptin may slightly increase risk of heart failure in some patients Advantages Over Other Classes: Weight neutral Low risk of hypoglycemia Well tolerated in the elderly Convenient once-daily dosing Limitations: Modest HbA1c reduction (0.50.8%) Not effective in Type 1 Diabetes Less potent than GLP-1 analogs or SGLT2 inhibitors Conclusion: DPP-4 inhibitors are a safe, effective, and well-tolerated option for many patients with T2DM especially those needing an add-on to metformin or who can't tolerate injectables

The association between obesity and cancer risk carries substantial public health ramifications as obesity promotes cancer advancement via many cellular and molecular mechanisms