sulfonylurea + dipeptidyl peptidase-4 inhibitor

This is a combination therapy consisting of a sulfonylurea (SU) and a dipeptidyl peptidase-4 inhibitor (DPP-4i), both of which are oral antidiabetic agents used in the management of type 2 diabetes mellitus. Sulfonylureas stimulate insulin secretion from pancreatic beta cells by inhibiting ATP-sensitive potassium channels, thereby increasing insulin release. DPP-4 inhibitors work by blocking the enzyme DPP-4, which degrades incretin hormones such as GLP-1; this results in increased endogenous incretin levels, enhancing glucose-dependent insulin secretion and suppressing glucagon release. The combination aims to provide additive or synergistic glucose-lowering effects through complementary mechanisms—direct stimulation of insulin secretion (SU) and enhancement of the incretin effect (DPP-4i). Clinical studies have shown that this combination can improve glycemic control and beta-cell function without significantly increasing hypoglycemia risk when low-dose SU is used[1][2][5]. However, standard-dose combinations may increase hypoglycemia risk[5].