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Regardless the differences in their chemical structure and metabolic pathways, gliptins as a group constitute a widely accepted therapy for the management of T2DM, usually as a second-line medication [27, 42, 153156]
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That confusion peaks in a key group
Eliminate bladder irritants, including caffeine, alcohol, citrus, and spicy foods, for two weeks to see if symptoms resolve
A Add a second oral agent (such as a sulfonylurea, thiazolidinedione, sodium-glucose cotransporter-2 inhibitor, or dipeptidyl peptidase 4 inhibitor), a glucagon-like peptide-1 (GLP-1) receptor agonist, or basal insulin if metformin at a maximum tolerated dose does not achieve the HbA1c target over 3 months
These observations are consistent with the mechanistic picture but have not yet been tested in dedicated randomized controlled trials
