Teneligliptin: expectations for its pleiotropic action

Introduction: The main aim in the management of diabetes mellitus is to prevent the development of its complications. Large fluctuations in glucose levels may increase the risk of complications, so improved control of glucose fluctuations, in addition to management of chronic hyperglycemia, could represent an important goal in diabetes pharmacotherapy. Areas covered: Pre-clinical and clinical studies suggest that poor control of blood glucose fluctuations contributes to progression of diabetic vascular complications. Dipeptidyl peptidase (DPP)-4 inhibitors are one of several drug classes used to manage diabetes, and the potential vasoprotective effects of DPP-4 inhibition have attracted attention in recent years. The DPP-4 inhibitor teneligliptin was approved in Japan in 2012 and in Korea in 2014. Teneligliptin differs in its structural and pharmacokinetic characteristics compared with other drugs in the same class. It appears to have potent, sustained effects on glycemic control, thereby reducing the complications of hypoglycemia and postprandial hyperglycemia. Because of its effects on vascular function, teneligliptin may be beneficial in patients at high risk of cardiovascular disease. Expert opinion: The possible pleiotropic effects of teneligliptin, such as those on endothelial function and metabolic syndrome, are of great interest. This review examines these effects and their potential clinical relevance.