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Evaluation of beta-cell secretory capacity using glucagon-like peptide 1.
Diabetes Care. 2000 Jun; 23(6):807-12.DC

Abstract

OBJECTIVE

Beta-cell secretory capacity is often evaluated with a glucagon test or a meal test. However, glucagon-like peptide 1 (GLP-1) is the most insulinotropic hormone known, and the effect is preserved in type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

We first compared the effects of intravenous bolus injections of 2.5, 5, 15, and 25 nmol GLP-1 with glucagon (1 mg intravenous) and a standard meal (566 kcal) in 6 type 2 diabetic patients and 6 matched control subjects. Next, we studied another 6 patients and 6 control subjects and, in addition to the above procedure, performed a combined glucose plus GLP-1 stimulation, where plasma glucose was increased to 15 mmol/l before injection of 2.5 nmol GLP-1. Finally, we compared the insulin response to glucose plus GLP-1 stimulation with that observed during a hyperglycemic arginine clamp (30 mmol/l) in 8 patients and 8 control subjects.

RESULTS

Peak insulin and C-peptide concentrations were similar after the meal, after 2.5 nmol GLP-1, and after glucagon. Side effects were less with GLP-1 than with glucagon. Peak insulin and C-peptide concentrations were as follows (C-peptide concentrations are given in parentheses): for patients (n = 12): meal, 277 +/- 42 pmol/l (2,181 +/- 261 pmol/l); GLP-1 (2.5 nmol), 390 +/- 74 pmol/l (2,144 +/- 254 pmol/l); glucagon, 329 +/- 50 pmol/l (1,780 +/- 160 pmol/l); glucose plus GLP-1, 465 +/- 87 pmol/l (2,384 +/- 299 pmol/l); for control subjects (n = 12): meal, 543 +/- 89 pmol/l (2,873 +/- 210 pmol/l); GLP-1, 356 +/- 51 pmol/l (2,001 +/- 130 pmol/l); glucagon, 420 +/- 61 pmol/l (1,995 +/- 99 pmol/l); glucose plus GLP-1, 1,412 +/- 187 pmol/l (4,391 +/- 416 pmol/l). Peak insulin and C-peptide concentrations during the hyperglycemic arginine clamp and during glucose plus GLP-1 injection were as follows: for patients: 475 +/- 141 pmol/l (2,295 +/- 379 pmol/l) and 816 +/- 268 pmol/l (3,043 +/- 508 pmol/l), respectively; for control subjects: 1,403 +/- 308 pmol/l (4,053 +/- 533 pmol/l) and 2,384 +/- 452 pmol/l (6,047 +/- 652 pmol/l), respectively.

CONCLUSIONS

GLP-1 (2.5 nmol = 9 microg) elicits similar secretory responses to 1 mg glucagon (but has fewer side effects) and a standard meal. Additional elevation of plasma glucose to 15 mmol/l did not enhance the response further. The incremental response was similar to that elicited by arginine, but hyperglycemia had an additional effect on the response to arginine.

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Authors+Show Affiliations

Vilsbøll T
Department of Internal Medicine F, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. tivi@gentoftehosp.kbhamt.dk
Toft-Nielsen MB
No affiliation info available
Krarup T
No affiliation info available
Madsbad S
No affiliation info available
Dinesen B
No affiliation info available
Holst JJ
No affiliation info available

MeSH

AgedBlood GlucoseC-PeptideDiabetes Mellitus, Type 2FemaleGlucagonGlucagon-Like Peptide 1HumansInjections, IntravenousInsulinInsulin SecretionIslets of LangerhansMaleMiddle AgedPeptide FragmentsPostprandial PeriodProtein PrecursorsReference ValuesTime Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10841001

Clinical Trial Links

Mechanisms of Insulin Resistance in Critical Illness: Role of Systemic Inflammation and GLP-1

Citation

Vilsbøll, T, et al. "Evaluation of Beta-cell Secretory Capacity Using Glucagon-like Peptide 1." Diabetes Care, vol. 23, no. 6, 2000, pp. 807-12.
Vilsbøll T, Toft-Nielsen MB, Krarup T, et al. Evaluation of beta-cell secretory capacity using glucagon-like peptide 1. Diabetes Care. 2000;23(6):807-12.
Vilsbøll, T., Toft-Nielsen, M. B., Krarup, T., Madsbad, S., Dinesen, B., & Holst, J. J. (2000). Evaluation of beta-cell secretory capacity using glucagon-like peptide 1. Diabetes Care, 23(6), 807-12.
Vilsbøll T, et al. Evaluation of Beta-cell Secretory Capacity Using Glucagon-like Peptide 1. Diabetes Care. 2000;23(6):807-12. PubMed PMID: 10841001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of beta-cell secretory capacity using glucagon-like peptide 1. AU - Vilsbøll,T, AU - Toft-Nielsen,M B, AU - Krarup,T, AU - Madsbad,S, AU - Dinesen,B, AU - Holst,J J, PY - 2000/6/7/pubmed PY - 2000/9/23/medline PY - 2000/6/7/entrez SP - 807 EP - 12 JF - Diabetes care JO - Diabetes Care VL - 23 IS - 6 N2 - OBJECTIVE: Beta-cell secretory capacity is often evaluated with a glucagon test or a meal test. However, glucagon-like peptide 1 (GLP-1) is the most insulinotropic hormone known, and the effect is preserved in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: We first compared the effects of intravenous bolus injections of 2.5, 5, 15, and 25 nmol GLP-1 with glucagon (1 mg intravenous) and a standard meal (566 kcal) in 6 type 2 diabetic patients and 6 matched control subjects. Next, we studied another 6 patients and 6 control subjects and, in addition to the above procedure, performed a combined glucose plus GLP-1 stimulation, where plasma glucose was increased to 15 mmol/l before injection of 2.5 nmol GLP-1. Finally, we compared the insulin response to glucose plus GLP-1 stimulation with that observed during a hyperglycemic arginine clamp (30 mmol/l) in 8 patients and 8 control subjects. RESULTS: Peak insulin and C-peptide concentrations were similar after the meal, after 2.5 nmol GLP-1, and after glucagon. Side effects were less with GLP-1 than with glucagon. Peak insulin and C-peptide concentrations were as follows (C-peptide concentrations are given in parentheses): for patients (n = 12): meal, 277 +/- 42 pmol/l (2,181 +/- 261 pmol/l); GLP-1 (2.5 nmol), 390 +/- 74 pmol/l (2,144 +/- 254 pmol/l); glucagon, 329 +/- 50 pmol/l (1,780 +/- 160 pmol/l); glucose plus GLP-1, 465 +/- 87 pmol/l (2,384 +/- 299 pmol/l); for control subjects (n = 12): meal, 543 +/- 89 pmol/l (2,873 +/- 210 pmol/l); GLP-1, 356 +/- 51 pmol/l (2,001 +/- 130 pmol/l); glucagon, 420 +/- 61 pmol/l (1,995 +/- 99 pmol/l); glucose plus GLP-1, 1,412 +/- 187 pmol/l (4,391 +/- 416 pmol/l). Peak insulin and C-peptide concentrations during the hyperglycemic arginine clamp and during glucose plus GLP-1 injection were as follows: for patients: 475 +/- 141 pmol/l (2,295 +/- 379 pmol/l) and 816 +/- 268 pmol/l (3,043 +/- 508 pmol/l), respectively; for control subjects: 1,403 +/- 308 pmol/l (4,053 +/- 533 pmol/l) and 2,384 +/- 452 pmol/l (6,047 +/- 652 pmol/l), respectively. CONCLUSIONS: GLP-1 (2.5 nmol = 9 microg) elicits similar secretory responses to 1 mg glucagon (but has fewer side effects) and a standard meal. Additional elevation of plasma glucose to 15 mmol/l did not enhance the response further. The incremental response was similar to that elicited by arginine, but hyperglycemia had an additional effect on the response to arginine. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/10841001/Evaluation_of_beta_cell_secretory_capacity_using_glucagon_like_peptide_1_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=10841001 DB - PRIME DP - Unbound Medicine ER -