Effect of glucagon-like peptide 1(7-36) amide on glucose effectiveness and insulin action in people with type 2 diabetes

Adrian Vella, Pankaj Shah, Rita Basu, Ananda Basu, Jens J. Holst, Robert A. Rizza

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Although it is well established that glucagon-like peptide 1(7-36) amide (GLP-1) is a potent stimulator of insulin secretion, its effects on insulin action and glucose effectiveness are less clear. To determine whether GLP-1 increases insulin action and glucose effectiveness, subjects with type 2 diabetes were studied on two occasions. Insulin was infused during the night on both occasions to ensure that baseline glucose concentrations were comparable. On the morning of study, either GLP-1 (1.2 pmol · kg-1 · min-1) or saline were infused along with somatostatin and replacement amounts of glucagon. Glucose also was infused in a pattern mimicking that typically observed after a carbohydrate meal. Insulin concentrations were either kept constant at basal levels (n = 6) or varied so as to create a prandial insulin profile (n = 6). The increase in glucose concentration was virtually identical on the GLP-1 and saline study days during both the basal- (1.21 ± 0.15 vs. 1.32 ± 0.19 mol/l per 6 h) and prandial (0.56 ± 0.14 vs. 0.56 ± 0.10 mol/l per 6 h) insulin infusions. During both the basal and prandial insulin infusions, glucose disappearance promptly increased after initiation of the glucose infusion to rates that did not differ on the GLP-1 and saline study days. Suppression of endogenous glucose production also was comparable on the GLP-1 and saline study days during both the basal (-2.7 ± 0.3 vs. -3.1 ± 0.2 μmol/kg) and prandial (-3.1 ± 0.4 vs. -3.0 ± 0.6 μmol/kg) insulin infusions. We conclude that when insulin and glucagon concentrations are matched, GLP-1 has negligible effects on either insulin action or glucose effectiveness in people with type 2 diabetes. These data strongly support the concept that GLP-1 improves glycemic control in people with type 2 diabetes by increasing insulin secretion, by inhibiting glucagon secretion, and by delaying gastric emptying rather than by altering extrapancreatic glucose metabolism.

Original languageEnglish (US)
Pages (from-to)611-617
Number of pages7
JournalDiabetes
Volume49
Issue number4
StatePublished - Apr 2000

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Type 2 Diabetes Mellitus
Glucagon-Like Peptide 1
Insulin
Glucose
Meals
Glucagon
glucagon-like peptide 1 (7-36)amide
Gastric Emptying
Somatostatin
Carbohydrates

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Effect of glucagon-like peptide 1(7-36) amide on glucose effectiveness and insulin action in people with type 2 diabetes. / Vella, Adrian; Shah, Pankaj; Basu, Rita; Basu, Ananda; Holst, Jens J.; Rizza, Robert A.

In: Diabetes, Vol. 49, No. 4, 04.2000, p. 611-617.

Research output: Contribution to journalArticle

Vella, A, Shah, P, Basu, R, Basu, A, Holst, JJ & Rizza, RA 2000, 'Effect of glucagon-like peptide 1(7-36) amide on glucose effectiveness and insulin action in people with type 2 diabetes', Diabetes, vol. 49, no. 4, pp. 611-617.
Vella, Adrian ; Shah, Pankaj ; Basu, Rita ; Basu, Ananda ; Holst, Jens J. ; Rizza, Robert A. / Effect of glucagon-like peptide 1(7-36) amide on glucose effectiveness and insulin action in people with type 2 diabetes. In: Diabetes. 2000 ; Vol. 49, No. 4. pp. 611-617.
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