Q: Is it true that sitagliptin (Januvia) preserves or increases pancreatic beta-cell function or quantity over a period of time?
A: Yes, there are data to suggest that the dipeptidyl peptidase IV (DPP-IV) inhibitors, which include sitagliptin, may preserve beta-cell mass to some extent. The implications of this fact for therapy in diabetes, however, are unclear. Some feel that DPP-IV inhibitors may one day have a use in new-onset type 1 diabetes to preserve residual beta-cell mass and function. Others feel DPP-IV inhibitors may have a use in prolonging islet-cell graft survival (Diabetes. 2009;58:641-651) following islet-cell transplantation. What is clear is that the benefits of these agents over other oral therapies for type 2 diabetes based on a possible prolongation of beta-cell survival have not been established. The impact on hemoglobin A1c, side-effect profile, and cost are still the main factors I use in deciding on an agent in the treatment of type 2 diabetes.