What is Type 2 diabetes in children?
Diabetes could be a condition within which the body cannot create enough endocrine, or cannot use endocrine commonly. a kind of polygenic disease could be a disorder. Endocrine could be a secretion. It helps sugar (glucose) within the blood get into cells of the body to be used as fuel. Once aldohexose can’t enter the cells, it builds up within the blood. This can be known as high blood glucose (hyperglycemia). High blood glucose will cause issues everywhere in the body. It will injure blood vessels and nerves. It will damage the eyes, kidneys, and heart.
Diabetes could be a condition within which the body cannot create enough endocrine, or cannot use endocrine commonly.
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| Type 2 diabetes in children |
A kind of polygenic disease could be a disorder. Endocrine could be a secretion. It helps sugar (glucose) within the blood get into cells of the body to be used as fuel. Once aldohexose can’t enter the cells, it builds up within the blood. This can be known as high blood glucose (hyperglycemia). High blood glucose will cause issues everywhere in the body. It will injure blood vessels and nerves. It will damage the eyes, kidneys, and heart.
Medical terms
Type 2 diabetes in children is a chronic sickness that affects the approach your juvenile body processes sugar (glucose) for fuel. While not treated, the disorder causes sugar to make up within the blood, which may result in serious long-run consequences.
Type two polygenic disorder happens a lot, usually in adults. In fact, it wants to be known as ketoacidosis-resistant diabetes mellitus. However, the increasing variety of youngsters with fleshiness has led to a lot of cases of kind two polygenic disorder in younger folks.
There's masses you'll do to assist, manage or stop two polygenic disorders in your kid. Encourage your kid to eat healthy foods, get lots of physical activity and maintain a healthy weight. If healthy uptake and exercise are not enough to manage two polygenic disorders, oral medication or hypoglycemic agent treatment could also be required.
Type 2 diabetes usually occurs in adults and is caused by a combination of factors including an unhealthy lifestyle and genetic factors But it's also on the rise among children which has led some to wonder: Can a child cure type 2 diabetes? The truth may surprise you Type 2 Diabetes Expert Explains.
Symptoms Type 2 diabetes in children
A type of polygenic disease typically includes a slow, gradual onset. Because of this, symptoms are troublesome to discover, and a few youngsters could have no symptoms in the least.
StatisticsTrusted supply show that concerning thirty four.2 million folks within the U.S. have polygenic disease, and 7.3 million of these might not have an identification.
The symptoms are similar in younger youngsters, adolescents, and adults.
Type A pair of polygenic diseases in youngsters could develop therefore step by step that there are not any noticeable symptoms. Sometimes, the disorder is diagnosed throughout a routine check-up.
Some youngsters would possibly expertise these signs and symptoms as a results of an excessive amount of sugar in their bloodstreams:
Increased thirst
Frequent urination
Increased hunger
Fatigue
Blurry vision
Darkened areas of skin, most often around the neck or in the armpits and groin
Unintended weight loss, although this is less common in children with type 2 diabetes than in children with type 1 diabetes
Frequent infections
When to see a doctor
See your child's health care supplier if you notice any of the signs or symptoms of kind two polygenic disorder. unknown, the sickness will cause serious injury.
Diabetes screening is usually recommended for kids UN agency have started pubescence or area unit a minimum of ten years recently, UN agency area unit overweight or rotund, and UN agency have a minimum of one alternative risk issue for kind two polygenic disorder.
Causes Type 2 diabetes in children
Problems with dominant glucose, or glucose, characterize polygenic disease. The duct gland sometimes helps someone manage their glucose by cathartic an internal secretion referred to as endocrine.
Insulin permits glucose to enter the cells, going away the blood and transferring down a person’s glucose level.
In a kid or adult with kind two polygenic disease, the body either doesn't turn out enough endocrine or develops endocrine resistance, during which the cells subsided sensitive to the results of this internal secretion.
Type two polygenic disease will develop in anyone, together with youngsters. The condition is additional probably to develop in individuals with overweight or blubber.
In the past, the medical profession named two polygenic diseases as either adult-onset or ketosis-resistant diabetes. However, the condition is going on in AN increasing variety of youngsters and adolescents as rates of blubber still rise.
The exact reason behind kind two polygenic disease is unknown. However, case history and genetic science seem to play a very important role. What's clear is that youngsters with two kinds of polygenic disease cannot measure sugar (glucose) properly.
Most of the sugar within the body comes from food. Once food is digestible, sugar enters the blood. Endocrine permits sugar to enter the cells — and lowers the number of sugar within the blood.
Insulin is made by an organ situated behind the abdomen referred to as the duct gland. The duct gland sends endocrine to the blood once food is eaten . Once the glucose level starts to drop, the duct gland slows down the secretion of endocrine into the blood.
When your kid has two kinds of polygenic disease, this method does not work additionally. As a result, rather than supplying cells, sugar builds up in your child's blood. this could happen because:
The pancreas may not make enough insulin
The cells become resistant to insulin and don't allow as much sugar in
Risk factors Type 2 diabetes in children
Researchers do not absolutely perceive why some kids develop a sort of polygenic disease et al. do not, albeit they need similar risk factors. However, it's clear that sure factors increase the danger, including:
Weight. Being overweight could be a sturdy risk issue for sorting a pair of polygenic disorders in kids. The additional fat kids have — particularly within and between the muscle and skin round the abdomen — the additional resistance their bodies' cells become to hypoglycemic agents.
Inactivity. The less active children are, the greater their risk of type 2 diabetes.
Diet. Eating red meat and processed meat and drinking sugar-sweetened beverages is associated with a higher risk of type 2 diabetes.
Family history. Children's risk of type 2 diabetes increases if they have a parent or sibling with the disease.
Race or ethnicity. Although it's unclear why, sure folks — together with Black, Hispanic, yankee Indian and Asian yankee folks — area unit a lot of probably to develop a pair of polygenic diseases.
Age and sex. Many children develop type 2 diabetes in their early teens, but it may occur at any age. Adolescent girls are more likely to develop type 2 diabetes than are adolescent boys.
Maternal gestational diabetes. Children born to women who had gestational diabetes during pregnancy have a higher risk of developing type 2 diabetes.
- Low birth weight or preterm birth. Having an occasional birth weight is related to the next risk of developing a pair of polygenic disorders. Babies born untimely — before thirty-nine to forty two weeks' gestation —have a larger risk of sorting a pair of polygenic disorders.Type A pair of polygenic disorders in youngsters is usually related to metabolic syndrome and polycystic gonad syndrome.
Metabolic syndrome
When certain conditions occur with blubber, they're related to hypoglycemic agent resistance and may increase the chance of polygenic disorder, polygenic disorder and cardiovascular disease and stroke. a mixture of the subsequent conditions is commonly known as metabolic syndrome:
High blood pressure
Low levels of high-density lipoproteins (HDL), the "good" cholesterol
High triglycerides
High blood sugar levels
Large waist size
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) affects young females when pubescence. PCOS is caused by associate degree imbalance of hormones, leading to signs like weight gain, irregular catamenial periods, and excess face and hair. individuals with PCOS usually have issues with metabolism which will lead to hormone resistance and sort two polygenic diseases.
Complications Type 2 diabetes in children
Type two polygenic disease will have an effect on nearly each organ in your juvenile body, together with the blood vessels, nerves, eyes and kidneys. The semipermanent complications of kind two polygenic disease develop bit by bit over a few years. Eventually, polygenic disease complications could also be severe or maybe dangerous.
Complications of kind two polygenic disease square measure associated with high glucose and include:
High cholesterol
Heart and blood vessel disease
Stroke
Nerve damage
Kidney disease
Eye disease, including blindness
Keeping your child's blood glucose level near to the quality vary most of the time will dramatically scale back the chance of those complications. you'll be able to facilitate your kid stop polygenic disorder complications by:
Working with your child to maintain good blood sugar control as much as possible
Teaching your child the importance of healthy eating and participating in regular physical activity
Scheduling regular visits with your child's diabetes treatment team
Can Ozempic be used for kids?
Ozempic is not recommended for anyone under the age of 19 because it has been known to cause serious liver damage in this population Ozempic is a strong medication that has the potential to be very harmful to a young person’s health Also no current studies have been done on people who are younger than 19 so there's no way to determine how these individuals would react.
What age is Ozempic approved for?
Ozempic is approved for adults whose blood pressure is not controlled by other drugs or have “isolated systolic hypertension” (high blood pressure in the arteries that supply blood to the organs of the body except for the heart) Ozempic should also be used if certain patients can’t tolerate ACE inhibitors and ARB medications The U.S Food and Drug Administration (FDA) recommends consulting a physician before taking this drug.
Prevention Type 2 diabetes in children
Healthy-lifestyle choices can help prevent type 2 diabetes in children. Encourage your child to:
Eat healthy foods. Offer your child foods low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
- Get more physical activity. Encourage your kid to become active. sign on your kid for a sports team or dance lessons.Better yet, create it a family affair. the approach to life selections will|which will|That may} facilitate stopping two polygenic diseases in kids that can be constant for adults.
Diagnosis Type 2 diabetes in children
To diagnose two polygenic diseases, a doctor can raise the child’s symptoms, and they could take a blood sample to envision aldohexose levels.
The doctor may additionally use a straightforward pee check to screen for sugar within the pee.
If polygenic disease is suspected, your child's health care supplier can probably suggest a screening check. Their square measures many blood tests to diagnose two kinds of polygenic disease in kids.
Random blood sugar test. A blood sample is taken at a random time, regardless of when your child last ate. A random blood sugar level of 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L), or higher suggests diabetes.
Fasting blood sugar test. A blood sample is taken once your kid hasn't had something to eat or drink, however water for a minimum of eight hours or long (fasting). A abstinence blood glucose level of 126 mg/dL (7.0 mmol/L) or higher suggests polygenic disorder.
Glycated hemoglobin (A1C) test. This test indicates your child's average blood sugar level for the past 3 months. An A1C level of 6.5% or higher indicates diabetes.
Oral glucose tolerance test. Your kid can ought to quickly drink a candied liquid at the health care provider's workplace or a laboratory testing website. glucose levels are tested periodically for future 2 hours. A glucose level of two hundred mg/dL (11.1 mmol/L) or higher typically suggests that your kid has polygenic disorder.
Additional tests
Your health care supplier might suggest extra tests to differentiate between sort one polygenic disease and kind two polygenic disease, as a result of treatment ways for every sort.
Treatment Type 2 diabetes in children
The treatment for a pair of polygenic disorders is typically similar in kids and adults, together with diet, lifestyle, and exercise recommendations, though the FDA have approved fewer medicine for youngsters.
A child with a pair of polygenic disorders may have to observe their blood sugar level frequently.
If a toddler is unable to try to do this themselves, a parent or caregiver may have preparation and coaching in the way to check a child’s blood sugar.
Teachers, coaches, and accountable care suppliers may go to shrewdness to administer hormone for youngsters with a kind one and a pair of polygenic disorders UN agency would like daily shots. different adults UN agencies might take care of the kid, like a keeper or relative, would force similar steering.
For children with a pair of polygenic disorders UN agency square measure taking hormone, caregivers may go to shrewdness and once to administer internal secretion shots in things wherever a child’s blood glucose level drops too much. internal secretion could be a secretion that stimulates the discharge of aldohexose from the liver. It is often important for reversing bouts of symptoms, or low blood glucose.
Daily fashion decisions square measure very necessary for youngsters with polygenic disorder. These embrace weight management, regular physical activity, and dietary changes.
Children taking hormones, and maybe all kids with polygenic disorder, ought to wear polygenic disorder bracelets that embrace important info just in case they become unresponsive throughout a hypoglycaemic episode.
The bracelet ought to scan “diabetes” on one facet and supply necessary details, like “insulin-controlled,” on the opposite.
This is particularly necessary for youngsters UN agency square measure taking hormones as a result of they will not understand the symptoms to an adequate degree to be ready to evoke facilitation. If a toddler loses consciousness as a result of low blood glucose, a polygenic disorder bracelet will facilitate associate adults perceive the proper medication necessary for treatment.
A doctor may inflict different medications that facilitate the body's response to hormones.
The doctor can individualize the treatment and diet set up in line with the child’s age and wishes and also the severity of the condition.
Treatment can depend upon your child’s symptoms, age, and general health. it'll conjointly depend upon however severe the condition is. The goal of treatment is to stay blood sugar levels as on the brink of traditional as doable.
Treatment for type 2 diabetes is lifelong and can include:
Healthy eating
Regular physical activity
Insulin or other medications
Blood sugar monitoring
Weight-loss surgery, in some cases
You'll work closely together with your child's polygenic disorder treatment team — as well as a health care supplier, certified polygenic disorder care and education specialist, registered dietician, and different specialists as required. The goal of treatment is to stay your child's glucose inside a precise vary. This {target vary|firing range|practice range} helps to stay at your child's glucose level as getting ready to the quality range as potential.
Your child's health care supplier can allow you to grasp what your child's glucose practice range is, and should additionally set an associated A1C target. These numbers might modify as your kid grows and changes so can your child's polygenic disorder treatment set up.
Healthy eating
Food could be a huge part of any polygenic disorder treatment arrangement, however that does not mean your kid has got to follow a strict "diabetes diet." Your health care supplier could advocate weight loss to attain and maintain a healthy weight. glucose levels will improve with weight loss.
Your kid's dietician can probably counsel that your child — and also the remainder of the family — consume foods that are unit high in biological process worth and low in fat and calories.
Healthy consumption includes a diet high in fruits, vegetables, nuts, whole grains and oil. select foods low in fat and calories and high in fiber. Eat a range of foods to assist accomplish your child's goals while not compromising style or nutrition.
Your child's dietician will assist you produce a hotel plan that matches your child's food preferences and health goals, yet assist you in arranging infrequent treats. Your dietician is additionally probably to advocate that your child:
Reduce portion sizes and not feel a need to finish everything on the plate
Substitute a fruit or vegetable for a carbohydrate-rich food
Replace high-calorie beverages, such as soft drinks or fruit juices, with water
Eat at home more frequently instead of eating at restaurants or getting food to carry out from restaurants
Help make meals
Eat at the dinner table instead of in front of the TV
Physical activity
Everyone wants regular cardiopulmonary exercise, and kids WHO have a pair of polygenic disorders are not any exception. Physical activity helps youngsters manage their weight, uses up sugar for energy, and makes the body use hormones a lot. This could lower blood glucose.
Make physical activity a part of your child's daily routine. Activity time does not have to be compelled to be all right away — it's okay to break it down into smaller chunks of your time. Encourage your kid to urge a minimum of an hour of physical activity daily or, better yet, exercise together with your kid.
Medication
There are three medications that have been approved by the Food and Drug Administration (FDA) for treating type 2 diabetes in children.
Metformin (Glumetza, others). This pill reduces the amount of sugar a child's liver releases into the bloodstream between meals and helps the body's cells use insulin more effectively.
Liraglutide (Victoza). This medication is taken by injection. Liraglutide helps the body unharness a lot of hormone from the exocrine gland once meals, once glucose levels square measure higher. This medication could have systema alimentarium facet effects, like nausea or looseness of the bowels.
- Insulin. Sometimes, endocrine is also required if your child's glucose levels measure terribly high. Endocrine permits sugar into the cells for energy, reducing the quantity of sugar within the blood.Their square measure variety of various insulins, however a long endocrine once on a daily basis, together with a short- or rapid-acting endocrine with meals, is usually used for sorting a pair of polygenic disorders in kids. Endocrine is usually delivered via a syringe or Associate in Nursing endocrine pen.With style changes and different medications, your kid is also able to be weaned off endocrine.
Blood sugar monitoring
Your health care supplier can allow you to be savvy . Usually you or your kid have to be compelled to check and record your child's glucose. youngsters WHO take internal secretion sometimes have to be compelled to check a lot of oft, presumably fourfold on a daily basis or a lot of.
Depending on treatment wants, continuous aldohexose observation is also a possibility. Frequent testing is solely thanks to confirm that your child's glucose level remains inside the firing range.
Weight loss surgery
These procedures don't seem to be an Associate in Nursing possibility for everybody. Except for teens, the United Nations agency area unit is considerably weighty — a body mass index (BMI) at or on top of thirty five — having weight-loss surgery might result in improved management of kind two polygenic disease.
Ongoing medical care
Your kid can want regular appointments to make sure smart polygenic disorder management. Visits along with your child's health care supplier will embrace a review of your child's glucose patterns, typical ingestion habits, physical activity, weight and drugs if taken. Healthy-lifestyle changes will cut back the requirement for medications.
Your health care supplier could check your child's A1C levels. The yank polygenic disorder Association usually recommends AN A1C of seven or lower for all youngsters and youths with polygenic disorder.
Your health care provider will also periodically check your child's:
Growth
Blood pressure
Cholesterol levels
Kidney and liver function
Eyes ⸺ usually annually
Feet
Risk of polycystic ovary syndrome and obstructive sleep apnea
Your kid's health care supplier can probably suggest a respiratory disorder shot for your child once a year, and should suggest the respiratory disease immunizing agent and also the COVID-19 immunizing agent if your kid is age five or older.
Signs of trouble
Despite your best efforts, generally issues can arise. Sure short complications of kind two polygenic disorders — like low glucose, high glucose, diabetic diabetic acidosis and hyperosmolar hyperglycemic state — need immediate care.
Low blood sugar (hypoglycemia)
Hypoglycemia could be a glucose level below your child's firing range. glucose levels will drop for several reasons, as well as skipping a meal, intake fewer carbohydrates than planned, obtaining a lot of physical activity than typical or injecting an excessive amount of internal secretion. youngsters with sort two polygenic disease have less risk of low glucose than do children with sort one polygenic disease.
Signs and symptoms of low blood sugar include:
Pallor
Shakiness
Hunger
Sweating
Irritability and other mood changes
Difficulty concentrating or confusion
Dizziness or lightheadedness
Loss of coordination
Slurred speech
Loss of consciousness
Seizures
Teach your kid the symptoms of low blood glucose. Once unsure, your kid should do a blood glucose check. If a blood sugar meter is not without delay on the market and your kid has symptoms of an occasional blood glucose, treat for low blood glucose and so check as shortly as doable.
If your kid includes a low blood glucose reading:
Give a fast-acting carbohydrate. Have your kid consume fifteen to twenty grams of a fast-acting macromolecule, like potable, aldohexose tablets, hard candy, regular (not diet) soda or another supply of sugar. Foods with addictive fat, like chocolate or frozen dessert, do not raise blood glucose as quickly as a result of fat slows down the absorption of the sugar.
Retest blood sugar. Retest your child's blood sugar in about 15 minutes to make sure it's back in the target range. If it's not, repeat giving a fast-acting carbohydrate and testing in 15 minutes as needed until you get a reading in your child's target range.
High blood sugar (hyperglycemia)
Hyperglycemia may be a glucose level on top of your child's practice range. glucose levels will rise for several reasons, as well as sickness, ingestion of an excessive amount of, ingestion bound sorts of foods, and not taking enough polygenic disorder medication or hormone.
Signs and symptoms of high blood sugar include:
Frequent urination
Increased thirst or dry mouth
Blurred vision
Fatigue
Nausea
If you believe symptoms, check your child's glucose. you would possibly have to be compelled to alter your child's hotel plan or medications. Contact your child's health care supplier if your child's glucose is frequently on top of his or her firing range.
Diabetes ketoacidosis
A severe lack of internal secretion causes your juvenile body to provide bound toxicant acids (ketones). If excess ketones build up, your kid might develop a doubtless severe condition called diabetic acidosis (DKA). DKA is common in youngsters with one kind of polygenic disease, however it will generally occur in youngsters with a pair of polygenic diseases.
Signs and symptoms of DKA include:
Thirst or very dry mouth
Increased urination
Dry or flushed skin
Nausea, vomiting or abdominal pain
A sweet, fruity smell on your child's breath
Confusion
If you think DKA, check your child's excretory product for excess organic compounds exploitation associate over-the-counter ketone check kit. If the organic compound levels are high, decide on your child's health care supplier or request emergency care.
Hyperosmolar hyperglycemic state
Hyperosmolar hyperglycemic state (HHS) could develop over a number of days in kids with two kinds of polygenic disease. The very high blood glucose level of Department of Health and Human Services Department of Health and Human Services 600 mg/dL or higher ⸺ could develop with severe infections, ill health or different medical conditions. The body's commitment to eliminate the high level of sugar by passing it within the pee ends up in severe dehydration.
Signs and symptoms of HHS include:
No or minimal ketones in the urine
Increased urination
Increased thirst
Dry mouth and warm, dry skin
Confusion or combativeness
Seizures
Coma
HHS can be life-threatening and requires emergency care.
Lifestyle and home remedies
Helping your kid follow the polygenic disorder treatment arrangement takes uninterrupted commitment. However, careful management of a pair of polygenic disorders will cut back your child's risk of great complications.
As your child gets older:
Encourage your child to take an increasingly active role in diabetes management
Stress the importance of lifelong diabetes care
Teach your child how to test blood sugar levels and to take medication and inject insulin if needed
Help your child make healthy food choices
Encourage your child to remain physically active and limit electronic screen time
Foster a relationship between your child and the diabetes treatment team
Make sure your child wears a medical identification tag
School and diabetes
You'll need to figure together with your child's faculty nurse and lecturers to make sure they understand the symptoms of high and low glucose levels. the college nurse may have to administer endocrine or check your child's glucose.
Federal law protects kids with polygenic disorders, and colleges should build cheap accommodations to make sure that everyone gets a correct education.
When to contact your diabetes care team
Contact your child's health care supplier, certified polygenic disease care and education specialist, or registered nutritionist between appointments if your child's blood glucose is systematically out of the practice range your health care supplier counseled. additionally contact the care team if you are not certain what to try and do in an exceedingly bound state of affairs.
Coping and support
Living with a sort of polygenic disorder is not straightforward — for you or for your kid. smart polygenic disorder management needs heaps of changes, particularly within the starting. That is why some polygenic disorder specialists frequently embrace a caseworker or scientist as a part of their polygenic disorder care groups. remember that you are not alone and your polygenic disorder treatment team will facilitate.
If you notice that your kid or adolescent is persistently unhappy or demoralized, or experiences dramatic changes in sleeping habits, friends or faculty performance, have your kid assessed for depression.
Rebellion conjointly could also be a difficulty, significantly for teens. a baby UN agency has been excellent concerning sticking out to the polygenic disorder treatment arrangement might rebel within the teenage years by ignoring polygenic disorder care. In addition, experimenting with medication, alcohol and smoking is even a lot of dangerous for folks with polygenic disorders.
Talking to a counselor or expert might facilitate your kid, otherwise you address the dramatic mode changes that accompany a designation of sorting a pair of polygenic disorders. Websites that supply support embrace the yankee polygenic disorder Association (ADA).
Preparing for your appointment
Your child's family health care supplier or podiatrist can most likely create the initial designation of polygenic disorder. However, you will probably then be noted as a specialist in metabolic disorders in youngsters (pediatric endocrinologist).
Your child's health care team additionally typically includes a licensed polygenic disorder care and education specialist and a registered specialist.
Here's some data to assist you make preparations for your appointment.
What you can do
Before your appointment take these steps:
Ask about any pre-appointment restrictions. If the health care supplier goes to check your child's blood glucose, your kid may have to be compelled to quickly for eight hours, looking at the kind of take a look at.
Make a list of any symptoms your child is experiencing, including any that may seem unrelated to the reason for your appointment.
Ask a family member or friend to join you, if potential. Managing polygenic disease needs you to recollect heaps of knowledge. somebody WHO accompanies you will recall one thing that you simply incomprehensible or forgot.
Make a list of questions to ask your healthcare provider.
Some basic questions to ask your child's health care provider include:
How often do I need to monitor my child's blood sugar?
What should my child's blood sugar levels be during the day and before bedtime?
What changes need to be made in the family diet?
How much exercise should my child get each day?
Will my child need to take medication? If so, what kind and how much?
What signs and symptoms of complications should I look for?
My child has another health condition. How can we best manage them together?
How often does my child need to be monitored for diabetes care? What specialists do we need to see?
Don't hesitate to ask additional questions during the appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
How comfortable are you with managing your child's diabetes?
What's a typical day's eating like for your child?
Is your child exercising? If so, how often?
How do you feel your child is coping with diabetes and its treatment?
General summary
Semaglutide is a synthetic analogue of the human glucagon-like peptide-1 (GLP-1) that mimics the biological activity of native GLP-1 As Semaglutide is derived from humans it can be used for both type 1 & 2 diabetes mellitus It belongs to a class of medicines called dipeptidyl peptidase IV (DPP4) inhibitors orGlucagon like peptide-1 receptor agonists It is indicated in combination with metformin and sulphonylurea as an adjunct to diet and exercise to improve glycemic control in adults.