ABCD position statement on incretin mimetics and DPP‐4 inhibitors ‐2009

The Association of British Clinical Diabetologists (ABCD) currently recommends a limited place for exenatide and the gliptins in obese type 2 diabetes. Exenatide requires careful patient selection and continued specialist support, particularly to avoid initiation in individuals at risk of pancreatitis or for those who are already on insulin therapy. Hypoglycaemic and weight reduction efficacy may vary depending on baseline levels of HbA1c and body mass index. Continuation of therapy beyond six months should be determined by changes in weight and/or HbA1c. Gliptins should be reserved for less obese, less hyperglycaemic cases than those considered for exenatide, assuming normal hepatorenal function, and where sulphonylureas and glitazones are inappropriate. Gliptin therapy should only continue beyond six months if HbA1c levels fall by at least 0.5%. Copyright ©2009 John Wiley & Sons.