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DPP-4 Inhibitors Mechanism of action Competitive inhibition of dipeptidyl-peptidase 4 slows degradation of endogenous incretins (GLP-1, GIP) Glucose-dependent insulin secretion Post-prandial glucagon release No direct effect on weight or insulin sensitivity Glycaemic efficacy Advantages Weight-neutral useful when metformin + SU cause weight concern Low hypoglycaemia risk (incretin-dependent action) Oral, generally once-daily