Secretion of glucagon-like peptide-1 (GLP-1) in type 2 diabetes: what is up, what is down?

M A Nauck, I Vardarli, C F Deacon, Jens Juul Holst, Joachim Meier

320 Citationer (Scopus)

Abstract

The incretin hormones gastric inhibitory polypeptide and especially glucagon-like peptide (GLP) have an important physiological function in augmenting postprandial insulin secretion. Since GLP-1 may play a role in the pathophysiology and treatment of type 2 diabetes, assessment of meal-related GLP-1 secretory responses in type 2 diabetic patients vs healthy individuals is of great interest. A common view states that GLP-1 secretion in patients with type 2 diabetes is deficient and that this applies to a lesser degree in individuals with impaired glucose tolerance. Such a deficiency is the rationale for replacing endogenous incretins with GLP-1 receptor agonists or re-normalising active GLP-1 concentrations with dipeptidyl peptidase-4 inhibitors. This review summarises the literature on this topic, including a meta-analysis of published studies on GLP-1 secretion in individuals with and without diabetes after oral glucose and mixed meals. Our analysis does not support the contention of a generalised defect in nutrient-related GLP-1 secretory responses in type 2 diabetes patients. Rather, factors are identified that may determine individual incretin secretory responses and explain some of the variations in published findings of group differences in GLP-1 responses to nutrient intake.
OriginalsprogEngelsk
TidsskriftDiabetologia
Vol/bind54
Udgave nummer1
Sider (fra-til)10-18
Antal sider9
ISSN0012-186X
DOI
StatusUdgivet - jan. 2011

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