Description

Vildagliptin is an oral medication for type 2 diabetes. It belongs to the class of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. It works by targeting an enzyme in the body to improve blood sugar control.

Indications

Vildagliptin is used to improve glycemic control in adults with type 2 diabetes mellitus. It is typically prescribed:

• As a monotherapy when metformin is considered inappropriate due to intolerance.
• In combination with other oral anti-diabetic medications, such as metformin, thiazolidinediones, or a sulfonylurea, when diet and exercise alone, or a single agent, do not provide adequate glycemic control.
• In combination with insulin (with or without metformin) when insulin plus diet and exercise do not provide adequate control.

Mechanism of Action

Vildagliptin works by enhancing the body’s own ability to regulate blood sugar levels. Its mechanism is focused on the incretin system.

1. DPP-4 Inhibition: Vildagliptin selectively inhibits the enzyme dipeptidyl peptidase-4 (DPP-4). This enzyme is responsible for breaking down a group of hormones called incretins, specifically glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).
2. Increased Incretin Levels: By inhibiting DPP-4, vildagliptin prevents the breakdown of these incretin hormones. This leads to higher circulating levels of active GLP-1 and GIP.
3. Glucose-Dependent Insulin Release: Incretins are secreted by the gut in response to food intake. When their levels are increased, they stimulate the pancreas to release insulin in a glucose-dependent manner. This means that insulin is released only when blood sugar levels are high, which reduces the risk of hypoglycemia (low blood sugar).
4. Reduced Glucagon Secretion: The higher levels of active incretins also suppress the release of glucagon from the pancreas. Glucagon is a hormone that signals the liver to produce and release glucose, especially between meals. By reducing glucagon, vildagliptin helps to lower blood glucose levels, particularly after a meal.

In essence, vildagliptin’s action is to make the body’s natural blood sugar regulation system work more effectively after meals without the risk of causing a severe drop in blood sugar.