The combination drug, alogliptin and pioglitazone, is used in the treatment of which one of the following systemic conditions?

• A. Type II diabetes
• B. Hypertension
• C. Hyperlipidemia
• D. Type I diabetes

Answer: (A)

The main concept is how combining a DPP-4 inhibitor with a thiazolidinedione targets the dysfunction seen in Type II diabetes. Alogliptin works by inhibiting DPP-4, which increases levels of incretin hormones like GLP-1 and GIP. These incretins enhance glucose-dependent insulin secretion from beta cells and suppress excess glucagon, helping to lower both fasting and postprandial glucose. Pioglitazone activates PPAR-gamma, improving insulin sensitivity in muscle and adipose tissue and reducing hepatic glucose production. Together, they address the two hallmark issues of Type II diabetes—insulin resistance and insufficient insulin action—so this combination is used for Type II diabetes. They’re not appropriate for Type I diabetes, where there is little to no endogenous insulin, nor are they first-line treatments for hypertension or hyperlipidemia.