DO DDP4 INHIBITORS  INCREASE BETA CELL MASS?

QUESTION-- what is the effect of of ddp4 inhibitors on c peptide ?and if increasing it does it mean beta cell regeneration? mailto:ymodmenna@gmail.com

RESPONSE--Your questions are good ones and a field of interest of mine.  Namely, can Dpp-4i and/or GLP-1 RAs increase beta cell mass and serve as a potential disease modifying agent in diabetes.The short answer is that the majority of research on this has been done in GLP-1 agents, with less in the DPP-4 arena.  GLP-1 agents have been shown to increase beta cell mass by promoting de novo beta cell generation, promoting beta cell differentiation from other precursor cells types, and increase beta cell survival by resisting apoptosis in ANIMALS (mostly rodent models).  However, this has been proven mostly to not be the case in humans, with the exception that the agents MAY help to reduce apoptosis.
To this end GLP-1 and DPP-4 agents have been pursued in type 1 diabetes to either prevent destruction of remaining cells, or to regenerate old ones.  No studies to date have been successful, but we are currently doing a study with novo nordisk looking at using liraglutide in newly diagnosed type 1 patients (in combination with another immunotheraptueic) to hopefully preserve beta cell mass.   Hope that helps. Jeremy Pettus, MD  California, USA