BENEFICIAL EFFECTS OF DPP-4 INHIBITOR IN THE TREATMENT OF TYPE 2 DIABETESProf Darmono, MD, PhD, Internist, EndocrinologistDiv of Endocrinology, Dept of Medicine, Med Fac, Diponegoro Univ, Kariadi HospitalSENDOMET, Sept 2014

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METFORMIN Hepatik glucose production Muscle glucose uptake Afinitas insulin reseptor Glukosa Insulin Status glikemi terkendali Vaskular growth factor Angiopati

MetforminAman jangka panjang(tidak ada gangguan perfusi)2

SULFONILUREAINSULINreseptorinsulin Hepatosithepatic Insulinclearance

insulin > lamadalam plasma glikogenolisis glukoneogenesis

glycogensynthase

glikogenesis pyruvate dehydrogenase

metabolik oksidatif glukosa intrasel muscleglucose uptake

hiperglikemi post prandialhepatic GlucoceProduction

hiperglikemiPuasa( - )( - )( - )( + )( + )( + )( + )3

T2 DM Insulin resist cell dysfunctionInterventionImprove Cell functionEffective

Preventing&DelayedProgression of DM

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IntestineEndocrinecells

Incretin(peptide hormones) GLP-1 Glucagon like peptide

GIP Glucose dependent insulinotropic peptideInsulin Cells

Improvefunction

XXEnzymeDipeptidyl peptidase-4(DPP-4)

28 daysPost prandial5DPP-4 inhibitor

AnimalStudy IFGClinicalStudy5 weeks

GIPBeneficialeffects

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