***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Inhibition of dipeptidyl peptidase-4 enhances the activity of incretin hormones , improving glycemic control in subjects with type 2 diabetes . This twelve-week r and omized , double-masked , placebo-controlled study assessed the efficacy and tolerability of the specific and potent oral dipeptidyl peptidase-4 inhibitor , vildagliptin ( 25 mg , bid , n=70 ) VS . placebo ( bid , n=28 ) in previously diet-treated subjects with type 2 diabetes . St and ardized meal tests were performed at baseline and endpoint . The between-group difference in adjusted mean change in HbA1c from baseline to endpoint was - 0.6 + /- 0.2 % ( p=0.0012 ) for the whole cohort ( baseline 8.0 % ) and -1.2 % for subjects with baseline HbA1c 8.0 - 9.5 % . Fasting glucose and mean pr and ial glucose were reduced by 1.1 + /- 0.4 ( p=0.0043 ) and 1.9 + /- 0.5 mmol/l ( p < 0.0001 ) , respectively . The between-group differences in corrected insulin response at peak glucose and mean pr and ial C-peptide were + 0.06 + /- 0.02 ( p=0.0258 ) and + 0.10 + /- 0.03 nmol/l ( p=0.0031 ) , respectively . Vildagliptin had no effect on fasting lipid levels or body weight . The incidence of adverse events was similar in subjects receiving placebo ( 71.4 % ) and vildagliptin ( 55.7 % ) . CONCLUSION monotherapy with vildagliptin is well tolerated and improves glycemic control in diet-treated subjects with type 2 diabetes . Concomitant improvements in beta-cell function were also observed . Subjects with higher baseline HbA1c levels showed greater response AIM To assess the safety and efficacy of the potent and selective dipeptidyl peptidase-4 inhibitor linagliptin 5 mg when given for 24 weeks to patients with type 2 diabetes who were either treatment-naive or who had received one oral antidiabetes drug ( OAD ) . METHODS This multicentre , r and omized , parallel group , phase III study compared linagliptin  treatment ( 5 mg once daily , n = 336 ) with placebo ( n = 167 ) for 24 weeks in type 2 diabetes patients . Before r and omization , patients pretreated with one OAD underwent a washout period of 6 weeks , which included a placebo run-in period during the last 2 weeks . Patients previously untreated with an OAD underwent a 2-week placebo run-in period . The primary endpoint was the change in HbA1c from baseline after 24 weeks of treatment . RESULTS Linagliptin treatment result ed in a placebo-corrected change in HbA1c from baseline of -0.69 % ( p < 0.0001 ) at 24 weeks . In patients with baseline HbA1c ≥ 9.0 % , the adjusted reduction in HbA1c was 1.01 % ( p < 0.0001 ) . Patients treated with linagliptin were more likely to achieve a reduction in HbA1c of ≥0.5 % at 24 weeks than those in the placebo arm ( 47.1 and 19.0 % , respectively ; odds ratio , OR = 4.2 , p < 0.0001 ) . Fasting plasma glucose improved by -1.3 mmol/l ( p < 0.0001 ) with linagliptin vs. placebo , and linagliptin produced an adjusted mean reduction from baseline after 24 weeks in 2-h postpr and ial glucose of -3.2 mmol/l ( p < 0.0001 ) . Statistically significant and relevant treatment differences were observed for proinsulin/insulin ratio ( p = 0.025 ) , Homeostasis Model Assessment -%B ( p = 0.049 ) and disposition index ( p = 0.0005 ) . There was no excess of hypoglycaemic episodes with linagliptin vs. placebo and no patient required third-party intervention . Mild or moderate renal impairment did not influence the trough plasma levels of linagliptin . CONCLUSIONS Monotherapy with linagliptin produced a significant , clinical ly meaningful and sustained improvement in glycaemic control , accompanied by enhanced parameters of β-cell function . The safety profile of linagliptin was comparable with that of placebo Abstract Objective : To evaluate the safety and efficacy of sitagliptin when added to the treatment of patients with type 2 diabetes mellitus ( T2DM ) and inadequate glycemic control on acarbose monotherapy . Research design and methods : This was a multicenter , r and omized , placebo-controlled , double-blind clinical trial . Patients ( N = 381 ) with T2DM and inadequate glycemic control ( glycated hemoglobin [ HbA1c ] ≥ 7.0 % and ≤10.0 % ) on acarbose monotherapy ( at least 50 mg three times daily ) were r and omized in a 1:1 ratio to receive the addition of sitagliptin 100 mg or matching placebo once daily for 24 weeks . Main outcome measures : Changes from baseline in HbA1c and fasting plasma glucose ( FPG ) at Week 24 . Results : The mean baseline HbA1c in r and omized patients was 8.1 % . At Week 24 , the placebo-controlled , least squares mean changes from baseline ( 95 % confidence interval ) in HbA1c and FPG in the sitagliptin group were −0.62 % and −0.8 mmol/L ( p < .001 ) , respectively . At Week 24 , 37.8 % of patients in the sitagliptin group were at HbA1c goal of < 7 % compared with 17.2 % in the placebo group ( p < .001 ) . Sitagliptin was generally well tolerated , and there were no significant between-group differences in prespecified safety parameters ( symptomatic hypoglycemia , diarrhea , abdominal pain , nausea , vomiting ) . A higher incidence of serious adverse events was observed in the sitagliptin group ( 5.2 % ) relative to placebo ( 0.5 % ) ; all but one , in the sitagliptin group , were not considered related to drug . Conclusions : Sitagliptin was generally well tolerated and provided statistically superior and clinical ly meaningful improvements in glycemic control after 24 weeks of treatment compared to placebo when added to treatment of patients with inadequate glycemic control on acarbose monotherapy . Clinical trials.gov : NCT01177384 Abstract Aims / Introduction Type 2 diabetes mellitus is a progressive disease that frequently requires patients to use more than one oral antihyperglycemic agent to achieve adequate glycemic control . The present multicenter , r and omized study assessed the efficacy and safety of the addition of sitagliptin to ongoing voglibose monotherapy ( 0.2–0.3 mg three times daily ) in Japanese patients with type 2 diabetes mellitus who had inadequate glycemic control ( glycated hemoglobin ≥6.9 % and < 10.5 % ) . Material s and Methods The present study had an initial 12‐week , double‐blind treatment period in which patients were r and omized ( 1:1 ) to sitagliptin 50 mg/day ( n = 70 )  or placebo ( n = 63 ) , followed by a 40‐week , open‐label treatment period during which all patients received sitagliptin 50 mg/day , that could have been increased to 100 mg/day for patients meeting predefined glycemic criteria . Results After 12 weeks , treatment with sitagliptin result ed in placebo‐subtracted mean changes from baseline in glycated hemoglobin ( the primary end‐point ) , fasting plasma glucose and 2‐h postmeal glucose of –0.9 % , –22.5 mg/dL and –51.3 mg/dL , respectively ( all , P < 0.001 ) . During the double‐blind period , adverse experiences were reported with similar frequency in both treatment groups , and the occurrences of hypoglycemia and gastrointestinal adverse experiences were low . In the open‐label period , sustained improvements in glycemic parameters were observed with sitagliptin treatment , and sitagliptin was generally well tolerated . Conclusions Sitagliptin added on to ongoing voglibose monotherapy provided significant improvements in glycemic parameters and was well tolerated in Japanese patients with type 2 diabetes mellitus who had inadequate glycemic control . This trial was registered with Clinical Trails.gov ( no. NCT00837577 ) Objective To compare the safety and efficacy of the dipeptidylpeptidase-4 ( DPP-4 ) inhibitors in patients with type 2 diabetes and inadequate glycemic control . Design Systematic review of r and omized controlled trials ( RCTs ) , health economic evaluation studies , systematic review s , and meta-analyses , followed by primary Bayesian mixed treatment comparison meta-analyses ( MTCs ) , and secondary frequentist direct-comparison meta-analyses using a r and om-effects model . Outcomes were reported as weighted mean change from baseline , or odds ratio ( OR ) with 95 % credible interval . Data sources MEDLINE , MEDLINE In-Process , EMBASE , and BIOSIS via Dialog ProQuest ; Cochrane Central Register of Controlled Trials and Cochrane Data base of Systematic Review s via EBSCO ; four diabetes and two technical congress abstract s ; and health technology assessment organization websites . Eligibility criteria Patients with type 2 diabetes and inadequate glycemic control receiving any pharmacological anti-diabetic treatment . Data extraction and analysis Title/ abstract s were review ed for eligibility , followed by full-text review of publications remaining after first pass . A three-person team filtered articles and an independent review er checked a r and om selection ( 10 % ) of filtered articles . Data extraction and quality assessment of studies were also independently review ed . Five DPP-4 inhibitors ( alogliptin , linagliptin , saxagliptin , sitagliptin , and vildagliptin ) were compared via meta- analysis ( where data were available ) as monotherapy , dual therapy ( plus metformin , sulfonylurea , pioglitazone , or insulin ) , and triple therapy ( plus metformin/sulfonylurea ) . Results The review identified 6,601 articles ; 163 met inclusion criteria and 85 publications from 83 RCTs contained sufficient or appropriate data for analysis . MTCs demonstrated no differences between DPP-4 inhibitors in mean change from baseline in glycosylated hemoglobin ( HbA1c ) or body weight , or the proportions of patients achieving HbA1c < 7 % or experiencing a hypoglycemic event , apart from in patients on alogliptin plus metformin , who achieved HbA1c < 7 % more frequently than those treated with saxagliptin plus metformin [ OR 6.41 ( 95 % CI 3.15–11.98 ) versus 2.17 ( 95 % CI 1.56–2.95 ) ] . Conclusions This systematic review and MTC showed similar efficacy and safety for DPP-4 inhibitors as treatment for type 2 diabetes , either as monotherapy or combination therapy BACKGROUND Previous studies reported that administration of first generation alpha-glucosidase inhibitors ( AGIs ) , such as voglibose or acarbose , produced exaggerated and sustained postpr and ial responses of glucagon-like peptide-1 ( GLP-1 ) , an incretin hormone from the enteroinsular axis , in healthy humans . Little is known about the postpr and ial release of GLP-1 after AGI therapy in diabetics . GLP-1 plays a role to mediate satiety . Any agent that substantially elevates GLP-1 levels may theoretically reduce hunger , increase satiation and limit food intake . OBJECTIVES This study was performed to analyse the effect of miglitol , a more potent second generation AGI with fewer gastrointestinal side-effects , on the regulation of meal-related GLP-1 secretion and on the change of insulin-glucose dynamics as well as the release of gastric inhibitory polypeptide ( GIP ) , another incretin hormone , after stimulation by an ordinary meal in obese type-2-diabetic subjects .  Miglitol 's subsequent influences on appetite sensations and food intake were also measured . DESIGN In total , 8 obese type-2-diabetic women were r and omized to receive treatment with 100 mg of miglitol or placebo three times a day for 2 days ( six doses total ) in a double-blind fashion . On day 3 of each treatment period ( miglitol or placebo ) , measurements of GLP-1 , GIP , insulin and glucose were taken periodically during 3 h after eating a 720 kcal breakfast . Appetite ratings with visual analogue scales ( VASs ) were used to assess ingestive behaviour hourly just before breakfast and hourly after for 6 h until immediately before lunch . The number of tuna s and wiches eaten at lunch was used to measure food consumption . RESULTS The plasma GLP-1 , gluc 
    Output:
    
The risks of hypoglycemia and gastrointestinal adverse events were similar between DPP4i/AGI and PCB/AGI .
The addition of a DPP4 inhibitor to patients with type 2 diabetes inadequately controlled with an AGI achieved better glycemic control without further increasing the risk of weight gain and hypoglycemia