Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral medicines that are routinely used to treat type 2 diabetes. They play an important role in glycemic management by targeting the incretin system, which regulates blood sugar levels. Incretins are hormones produced by the gut in response to meal consumption that stimulate insulin production from the pancreas in a glucose-dependent way. DPP-4 is an enzyme that rapidly destroys incretins, specifically glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). By inhibiting DPP-4, these drugs extend the action of GLP-1 and GIP, resulting in enhanced insulin release and decreased glucagon secretion. This method promotes glucose-dependent insulin secretion, which means that insulin release is triggered by high blood glucose levels, reducing the risk of hypoglycemia. One of the primary benefits of DPP-4 inhibitors is their low side effect profile. They are generally well tolerated and do not promote weight gain, making them a popular choice among many patients. Sitagliptin, saxagliptin, linagliptin, and alogliptin are among the most commonly prescribed DPP-4 inhibitors.DPP-4 inhibitors are often given orally, which makes them more practical for patients who prefer oral drugs versus injections. They can be taken alone or in combination with other anti-diabetic medications such metformin, sulfonylureas, and thiazolidinediones. However, it is crucial to remember that DPP-4 inhibitors may have some limitations. While they improve glucose control, their effect in reducing long-term diabetic complications is still being studied. Furthermore, some patients may be concerned about the expense of these medications, as they are more expensive than some other antidiabetic treatments. To summarize, DPP-4 inhibitors are a valuable addition to the arsenal of medicines available for controlling T2DM. They provide a well-tolerated and convenient choice for anyone looking for excellent glycemic management with little risk of hypoglycemia and few side effects. However, like with any drug, specific patient circumstances and preferences must be considered while selecting the best treatment approach.