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Glucagon‐like peptide‐1 (GLP‐1): a trial of treatment in non‐insulin‐dependent diabetes mellitus
Author(s) -
TODD J. F.,
WILDING J. P. H.,
EDWARDS C. M. B.,
KHAN F. A.,
GHATEI M. A.,
BLOOM S. R.
Publication year - 1997
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1997.1490691.x
Subject(s) - postprandial , medicine , crossover study , glucagon , endocrinology , glucagon like peptide 1 , gastric emptying , insulin , diabetes mellitus , saline , area under the curve , meal , gastric inhibitory polypeptide , incretin , type 2 diabetes , stomach , placebo , alternative medicine , pathology
Glucagon‐like peptide‐1 (7–36) amide (GLP‐1) is released from the gut into the circulation after meals and is the most potent physiological insulinotropic hormone in man. In contrast to presently available therapeutic agents for non‐insulin‐dependent diabetes mellitus (NIDDM), GLP‐1 has the advantages of both suppressing glucagon secretion and delaying gastric emptying. We report the first chronic study of subcutaneous (s/c) GLP‐1 treatment in NIDDM. Five patients with poorly controlled NIDDM were entered into a six‐week, double‐blind crossover trial. Each received three weeks treatment with s/c GLP‐1 40 nmol or saline, given three times a day immediately before meals. A standardized test meal was given at the beginning and end of each treatment period. GLP‐1 reduced plasma glucose area under the curve (AUC) following the standard test meal by 25% (AUC, 0–180 mins, GLP‐1 start of treatment 482.2 ± 38.2 vs. saline start of treatment 635.7 ± 45.4 mmol min L −1 , F = 16.4, P < 0.02). The beneficial effect of GLP‐1 on plasma glucose concentration was fully maintained for the three‐week treatment period. Plasma glucagon levels were significantly lower for 60 min postprandially after GLP‐1 treatment. In this group of patients there was no significant increase in postprandial insulin levels with GLP–1. We have demonstrated a significant improvement in postprandial glycaemic control with s/c GLP‐1 treatment that was fully maintained over a three‐week treatment period. GLP‐1 improves glycaemic control even in the absence of an insulinotropic effect and is a potential treatment for NIDDM.