Secretion of Glucagon-Like peptide-1 (GLP-1) in Type 2 Diabetes: What Is Up, What Is Down?

Diabetologia. 2011 Jan;54(1):10-8. doi: 10.1007/s00125-010-1896-4. Epub 2010 Sep 25.

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.

Publication types

  • Review

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 2 / metabolism*
  • Glucagon-Like Peptide 1 / metabolism*
  • Humans
  • Incretins / metabolism
  • Meta-Analysis as Topic
  • Models, Biological

Substances

  • Incretins
  • Glucagon-Like Peptide 1