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When the insulin receptors are activated, they undergo autophosphorylation of tyrosine residues and trigger intracellular signaling pathways, including the phosphatidylinositol-3-kinase (PI3K) and protein kinase B (PKB/Akt) pathways

The D-isomer (Dextroamphetamine) is more potent than the L-isomer (Levoamphetamine)

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Whether glucagon counter-regulation to hypoglycemia is affected during DPP-4 inhibition in type 2 diabetes has been studied in drug-nave subjects (138), in subjects when a DPP-4 inhibition was added on to insulin therapy (139), and in elderly subjects with metformin-treated type 2 diabetes (140)