Involvement of glucagon-like peptide-1 in the glucose-lowering effect of metformin

Emilie Bahne, Morten Hansen, Andreas Brønden, David P Sonne, Tina Vilsbøll Lauritsen, Filip K Knop

36 Citations (Scopus)

Abstract

Metformin is an oral antihyperglycaemic drug used in the first-line treatment of type 2 diabetes. Metformin's classic and most well-known blood glucose-lowering mechanisms include reduction of hepatic gluconeogenesis and increased peripheral insulin sensitivity. Interestingly, intravenously administered metformin is ineffective and recently, metformin was shown to increase plasma concentrations of the glucose-lowering gut incretin hormone glucagon-like peptide-1 (GLP-1), which may contribute to metformin's glucose-lowering effect in patients with type 2 diabetes. The mechanisms behind metformin-induced increments in GLP-1 levels remain unknown, but it has been hypothesized that metformin stimulates GLP-1 secretion directly and/or indirectly and that metformin prolongs the half-life of GLP-1. Also, it has been suggested that metformin may potentiate the glucose-lowering effects of GLP-1 by increasing target tissue sensitivity to GLP-1. The present article critically reviews the possible mechanisms by which metformin may affect GLP-1 levels and sensitivity and discusses whether such alterations may constitute important and clinically relevant glucose-lowering actions of metformin.

Original languageEnglish
JournalDiabetes, Obesity and Metabolism Online
Volume18
Issue number10
Pages (from-to)955-61
Number of pages7
ISSN1463-1326
DOIs
Publication statusPublished - 1 Oct 2016

Keywords

  • Journal Article
  • Review

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