Empagliflozin + Linagliptin

Linagliptin blocks the DPP-4 enzyme, which breaks down the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). With the enzyme blocked, the level of active incretin hormones goes up. This stimulates the release of insulin in a glucose-dependent manner and lowers the level of glucagon. Both hormones take part in the body's normal regulation of glucose homeostasis. They are secreted at a low basal level through the day, and their levels rise straight after a meal. GLP-1 and GIP increase insulin biosynthesis and secretion from the pancreatic beta cells, whether blood glucose is normal or raised. GLP-1 also reduces glucagon secretion from the pancreatic alpha cells, and this lowers the glucose output from the liver. Empagliflozin inhibits the sodium-glucose co-transporter 2 (SGLT2). SGLT2 is the main transporter that takes glucose from the kidney back into the circulation. By blocking it, Empagliflozin reduces the kidney's reabsorption of filtered glucose and lowers the renal threshold for glucose, so more glucose is passed out in the urine.