Diabetologia

, Volume 36, Issue 8, pp 741–744 | Cite as

Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in Type 2 (non-insulin-dependent) diabetic patients

  • M. A. Nauck
  • N. Kleine
  • C. Ørskov
  • J. J. Holst
  • B. Willms
  • W. Creutzfeldt
Originals

Summary

Glucagon-like peptide 1 (GLP-1) (7-36 amide) is a physiological incretin hormone that is released after nutrient intake from the lower gut and stimulates insulin secretion at elevated plasma glucose concentrations. Previous work has shown that even in Type 2 (non-insulin-dependent) diabetic patients GLP-1 (7-36 amide) retains much of its insulinotropic action. However, it is not known whether the magnitude of this response is sufficient to normalize plasma glucose in Type 2 diabetic patients with poor metabolic control. Therefore, in 10 Type 2 diabetic patients with unsatisfactory metabolic control (HbAlc 11.6±1.7%) on diet and sulphonylurea therapy (in some patients supplemented by metformin or acarbose), 1.2 pmol ×kg−1×min−1 GLP-1 (7-36 amide) or placebo was infused intravenously in the fasting state (plasma glucose 13.1±0.6 mmol/l). In all patients, insulin (by 17.4±4.7 nmol ×1−1×min; p=0.0157) and C-peptide (by 228.0±39.1 nmol×1−1×min; p=0.0019) increased significantly over basal levels, glucagon was reduced (by -1418±308 pmol ×1−1×min) and plasma glucose reached normal fasting concentrations (4.9±0.3 mmol/l) within 4 h of GLP-1 (7-36 amide) administration, but not with placebo. When normal fasting plasma glucose concentrations were reached insulin returned towards basal levels and plasma glucose concentrations remained stable despite the ongoing infusion of GLP-1 (7-36 amide). Therefore, exogenous GLP-1 (7-36 amide) is an effective means of normalizing fasting plasma glucose concentrations in poorly-controlled Type 2 diabetic patients. The glucose-dependence of insulinotropic actions of GLP-1 (7-36 amide) appears to be retained in such patients.

Key words

Type 2 (non-insulin-dependent) diabetes mellitus incretin hormones glucagon-like peptide 1 (7-36 amide) pancreatic glucagon enteroinsular axis 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • M. A. Nauck
    • 1
    • 4
  • N. Kleine
    • 2
  • C. Ørskov
    • 3
  • J. J. Holst
    • 3
  • B. Willms
    • 2
  • W. Creutzfeldt
    • 1
  1. 1.Division of Gastroenterology and Endocrinology, Department of MedicineGeorg-August-UniversityGöttingenGermany
  2. 2.Fachklinik für Diabetes und StoffwechselkrankheitenBad LauterbergGermany
  3. 3.Departments of Anatomy B and Physiology CPanum InstituteCopenhagenDenmark
  4. 4.Medizinische Klinik der Ruhr-Universität im Knappschafts-KrankenhausBochumGermany

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