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The effect of Glucagon-Like Peptide-1 Receptor blockade on islet secretion and glucose metabolism in humans.


ABSTRACT:

Background

Proglucagon can be processed to Glucagon-Like Peptide-1 (GLP-1) within the islet but its contribution to islet function in humans remains unknown. We sought to understand whether 'pancreatic' GLP-1 alters islet function in humans and whether this is affected by type 2 diabetes.

Methods

We therefore studied individuals with and without type 2 diabetes on 2 occasions in random order. On one occasion exendin 9-39, a competitive antagonist of the GLP-1 Receptor (GLP1R), was infused, while on the other saline was infused. The tracer dilution technique ([3-3H] glucose) was used to measure glucose turnover during fasting and during a hyperglycemic clamp.

Results

Exendin 9-39 increased fasting glucose concentrations; fasting islet hormone concentrations were unchanged, but inappropriate for the higher fasting glucose observed. In people with type 2 diabetes fasting glucagon concentrations were markedly elevated and persisted despite hyperglycemia. This impaired suppression of endogenous glucose production by hyperglycemia. These data show that GLP1R blockade impairs islet function, implying that intra-islet GLP1R activation alters islet responses to glucose and does so to a greater degree in people with type 2 diabetes.

SUBMITTER: Welch AA 

PROVIDER: S-EPMC10645389 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Glucagon-like peptide-1 receptor blockade impairs islet secretion and glucose metabolism in humans.

Welch Andrew A AA   Farahani Rahele A RA   Egan Aoife M AM   Laurenti Marcello C MC   Zeini Maya M   Vella Max M   Bailey Kent R KR   Cobelli Claudio C   Dalla Man Chiara C   Matveyenko Aleksey A   Vella Adrian A  

The Journal of clinical investigation 20231115 22


BACKGROUNDProglucagon can be processed to glucagon-like peptide1 (GLP-1) within the islet, but its contribution to islet function in humans remains unknown. We sought to understand whether pancreatic GLP-1 alters islet function in humans and whether this is affected by type 2 diabetes.METHODSWe therefore studied individuals with and without type 2 diabetes on two occasions in random order. On one occasion, exendin 9-39, a competitive antagonist of the GLP-1 Receptor (GLP1R), was infused, while o  ...[more]

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