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Sitagliptin is the first of a class of drugs to be approved that mimics the actions of the dipeptidyl peptidase-4 (DPP-4) enzyme.

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Physiological Effects Semaglutide exerts its therapeutic benefits through multiple complementary mechanisms: Enhanced Insulin Secretion: Stimulates glucose-dependent insulin release from pancreatic beta cells, improving postprandial glucose control[3][4] Glucagon Suppression: Inhibits glucagon release, reducing hepatic glucose production and improving fasting blood glucose levels[3][4] Delayed Gastric Emptying: Slows the movement of food from the stomach to the small intestine, reducing postprandial glucose excursions and promoting satiety[4][5] Appetite Reduction: Directly affects the central nervous system to decrease food intake and energy consumption[4][5] Improved Metabolic Flexibility: Enhances the body's ability to switch between energy substrates based on availability[2] At the cellular level, semaglutide primarily operates through the AMPK (AMP-activated protein kinase) pathway, which regulates cellular energy homeostasis and improves insulin sensitivity

The global incretin-based drugs market was valued at USD 39.4 billion in 2025 and is projected to grow from USD 41.6 billion in 2026 to USD 72.6 billion by 2035, expanding at a CAGR of 6.4% between 2026 and 2035, driven by the rising prevalence of type 2 diabetes mellitus.

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