TY - JOUR
T1 - Secretion of glucagon-like peptide-1 in patients with type 2 diabetes mellitus
T2 - systematic review and meta-analyses of clinical studies
AU - Calanna, S
AU - Christensen, M
AU - Holst, Jens Juul
AU - Laferrère, B
AU - Gluud, L L
AU - Vilsbøll, T
AU - Knop, F K
PY - 2013/5
Y1 - 2013/5
N2 - Aims/hypothesis: We carried out a systematic review of clinical studies investigating glucagon-like peptide-1 (GLP-1) secretion in patients with type 2 diabetes and non-diabetic controls and performed meta-analyses of plasma total GLP-1 concentrations during an OGTT and/or meal test. Methods: Random effects models for the primary meta-analysis and random effects meta-regression, subgroup and regression analyses were applied. Results: Random effects meta-analysis of GLP-1 responses in 22 trials during 29 different stimulation tests showed that patients with type 2 diabetes (n = 275) and controls without type 2 diabetes (n = 279) exhibited similar responses of total GLP-1 (p = NS) as evaluated from peak plasma concentrations (weighted mean difference [95% CI] 1.09 pmol/l [-2.50, 4.67]), total AUC (tAUC) (159 pmol/l×min [-270, 589]), time-corrected tAUC (tAUC min-1) (0.99 pmol/l [-1.28, 3.27]), incremental AUC (iAUC) (-122 pmol/l×min [-410, 165]) and time-corrected iAUC (iAUC min-1) (-0.49 pmol/l [-2.16, 1.17]). Fixed effects meta-analysis revealed higher peak plasma GLP-1 concentrations in patients with type 2 diabetes. Subgroup analysis showed increased responses after a liquid mixed meal test (peak, tAUC and tAUC min-1) and after a 50 g OGTT (AUC and tAUC min-1), and reduced responses after a solid mixed meal test (tAUC min-1) among patients with type 2 diabetes. Meta-regression analyses showed that HbA1c and fasting plasma glucose predicted the outcomes iAUC and iAUC min-1, respectively. Conclusions/interpretation: The present analysis suggests that patients with type 2 diabetes, in general, do not exhibit reduced GLP-1 secretion in response to an OGTT or meal test, and that deteriorating glycaemic control may be associated with reduced GLP-1 secretion.
AB - Aims/hypothesis: We carried out a systematic review of clinical studies investigating glucagon-like peptide-1 (GLP-1) secretion in patients with type 2 diabetes and non-diabetic controls and performed meta-analyses of plasma total GLP-1 concentrations during an OGTT and/or meal test. Methods: Random effects models for the primary meta-analysis and random effects meta-regression, subgroup and regression analyses were applied. Results: Random effects meta-analysis of GLP-1 responses in 22 trials during 29 different stimulation tests showed that patients with type 2 diabetes (n = 275) and controls without type 2 diabetes (n = 279) exhibited similar responses of total GLP-1 (p = NS) as evaluated from peak plasma concentrations (weighted mean difference [95% CI] 1.09 pmol/l [-2.50, 4.67]), total AUC (tAUC) (159 pmol/l×min [-270, 589]), time-corrected tAUC (tAUC min-1) (0.99 pmol/l [-1.28, 3.27]), incremental AUC (iAUC) (-122 pmol/l×min [-410, 165]) and time-corrected iAUC (iAUC min-1) (-0.49 pmol/l [-2.16, 1.17]). Fixed effects meta-analysis revealed higher peak plasma GLP-1 concentrations in patients with type 2 diabetes. Subgroup analysis showed increased responses after a liquid mixed meal test (peak, tAUC and tAUC min-1) and after a 50 g OGTT (AUC and tAUC min-1), and reduced responses after a solid mixed meal test (tAUC min-1) among patients with type 2 diabetes. Meta-regression analyses showed that HbA1c and fasting plasma glucose predicted the outcomes iAUC and iAUC min-1, respectively. Conclusions/interpretation: The present analysis suggests that patients with type 2 diabetes, in general, do not exhibit reduced GLP-1 secretion in response to an OGTT or meal test, and that deteriorating glycaemic control may be associated with reduced GLP-1 secretion.
U2 - 10.1007/s00125-013-2841-0
DO - 10.1007/s00125-013-2841-0
M3 - Journal article
C2 - 23377698
SN - 0012-186X
VL - 56
SP - 965
EP - 972
JO - Diabetologia
JF - Diabetologia
IS - 5
ER -
