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Patients with severe renal impairment who took vidagliptin displayed a higher rate of infections and infestations than patients taking placebo.

The drug combination that seems most logical is incretin-based therapies (addressing 4 out of the 8 pathophysiological mechanisms) with biguanide (metformin) or TZD (addressing insulin resistance at liver and skeletal muscle).

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However, unlike exenatide, which is given by injection, DPP-4 inhibitor drugs are taken as pills by mouth.

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All this has already been accomplished by the original manufacturer, and was subsequently reflected in the brand-name drug price.

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In October 2006, the FDA approved the first DPP-4 inhibitor.

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These studies have shown that administration of insulin, IGF-1 and GLP-1 agonists reverses signaling abnormalities and has positive effects on surrogate markers of neurodegeneration and behavioral outcomes.

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