OBJECTIVE: Diabetic nephropathy (DN) has become the major complication of diabetes. The progression of the disease impedes the efficacy of DN treatment. Therefore. the strategies to inhibit or reverse kidney damage in DN patients are of critical importance. We aim to investigate the effect of sitagliptin on DN within rat model and analyze the associated metabolism and expression of iNOS/GLP-1 receptor. MATERIALS AND METHODS: Diabetic model was generated by using Sprague-Dawley (SD) rats. which received an intra-peritoneal injection of 30 mg/kg streptozotocin. Rats were then treated with saline or 15 mg/(kg.d) sitagliptin by gavage. After 12 weeks, fasting blood glucose and insulin resistance were measured. Rat glucose and lipid metabolism were evaluated by high triglyceride (TG), total cholesterol (TC). high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Western blot was used to measure expression of glucose-6-phosphatase (G6Pase), phosphoenolpyruvate carboxykinase (PEPCK), fatty acid synthase (FAS) and acetyl-CoA carboxylase (ACC) related with glucose-lipid metabolism, and expression of iNOS and GLP-1 expression in kidney tissues. RESULTS: After 12 weeks of feeding. the levels of blood glucose and lipid in sitagliptin group were significantly decreased compared to those in control group (p<0.05), whilst insulin sensitivity was enhanced (p<0.05). Western blot showed that sitagliptin downregulated the expressions of glucose-lipid metabolism proteins such as G6Pase, PEPCK, ACC and FAS in rat livers, inhibited iNOS expression in kidneys and elevated GLP-1 receptor activity (p<0.05). CONCLUSIONS: Sitagliptin effectively stabilizes blood glucose and lipid levels in DN rats, significantly improves glucose-lipid metabolism and protects kidney and vascular endothelial cells during DN pathogenesis through inhibiting iNOS expression and elevating GLP-1 receptor activity.