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This inhibition consecutively leads to post-prandial GLP-1 plasma concentrations that are elevated 2-3-fold and mediates the glucose-dependent stimulation of insulin secretion and inhibition of glucagon secretion (Table 1 gives a summary of the clinical phase III studies with at least 52 weeks duration on the efficacy of DPP-4 inhibitors compared to sulfonylureas as add on therapy to metformin, respectively, in patients not reaching their glycaemic goals with a monotherapy of metformin