Relationship between postprandial glucagon-like peptide 1, glucagon levels and short and long- acting insulin requirement in C-peptide negative type 1 diabetic patients (CROSBI ID 598759)
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Podaci o odgovornosti
Zibar, Karin ; Bulum, Tomislav ; Blaslov, Kristina ; Duvnjak, Lea
engleski
Relationship between postprandial glucagon-like peptide 1, glucagon levels and short and long- acting insulin requirement in C-peptide negative type 1 diabetic patients
It has been suggested that glucagon-like peptide 1 (GLP-1) in C-peptide negative type 1 diabetic (T1DM) patients decreases glucose concentration through reducing glucagon secretion. Although mechanisms by which GLP-1 affects glucagon secretion has not been well understood, in patients with preserved GLP-1 secretion decreased glucagon secretion and improved glucose control were documented. We assessed the difference in postprandial total GLP-1 level in relation to glucagon secretion and both, short and long-acting insulin requirement in 79 C-peptide negative T1DM patients (median age 46 years, T1DM duration of median 21 years, hemoglobin A1c median level 7.3%, short-acting insulin requirement mean 0.1 and long-acting insulin requirement median 0.3 unit/kg/day). Plasma total GLP-1 and glucagon levels were measured by ELISA assay (DRG Diagnostic, Germany). The group of patients with higher postprandial total GLP-1 concentration (≥2.6 pmol/L, n=40) required lower dose of long- acting insulin (0.28 vs 0.31, p=0.043), had higher fasting total GLP-1 concentration (1.25 vs 0.82, p=0.007), fasting glucagon (118.1 vs 95.3 pg/mL, p=0.048) and postprandial glucagon (126.6 vs 99.1, p=0.007) concentration. There was no difference in short-acting insulin requirement (p=0.053). Inappropriate elevation of glucagon could be explained by lack of inhibition of glucagon secretion due to low total GLP-1 concentration documented in our patients. Lower total GLP-1 concentration in our patients might be explained by insulin therapy causing an increase in serum dipeptidyl peptidase IV activity (DPP-IV), which was recently reported in T1DM patients. Endogenously secreted GLP-1 plays an important role in glucoregulation in T1DM by modulating glucagon levels. The complex interplay between GLP-1, glucagon secretion and exogenously administered insulin should be investigated in future clinical trials of T1DM.
glucagon-like peptide 1; glucagon; type 1 diabetes
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Podaci o prilogu
2013.
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objavljeno
Podaci o matičnoj publikaciji
Diabetes (New York, N.Y.)
0012-1797
Podaci o skupu
73rd Scientific Sessions of American Diabetes Association
poster
21.06.2013-25.06.2013
Chicago (IL), Sjedinjene Američke Države