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These DPP-4 inhibitors work by inhibiting the breakdown of incretin. Higher incretin levels thus leads to both lower glucagon & higher insulin levels, both of which lower glucose and tend to delay gastric emptying. Alternatively, one can increase incretin by injecting either exenatide (Byetta) or liraglutide (Victoza) .
The good news for our patients w/diabetes is that they have many options from which to choose to assist them in lowering their blood sugars and minimizing their risk for dying early or suffering from heart attacks, strokes, kidney failure, amputations, and erectile dysfunction. However, as providers, we have to look long & hard to see if new therapies have any decided advantage over (slightly) older options, which by now have hopefully demonstrated safety. So never be the first but never be the last to prescribe a new medication. But above all else, do not harm. 
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