engleski

The emerging role of incretins in the pathophysiology of insulin resistance in type 1 diabetes

The pathophysiology of insulin resistance (IR) comprises a complex adipokine-mediated crosstalk between white adipose tissue and other organs. Although it is prominent feature of Type 2 diabetes, a certain degree of IR also exists in Type 1 diabetes (T1DM). Incretins are gut derived hormones secreted into the circulation in response to nutrient ingestion that enchances glucose- stimulated insulin secretion. One of the main incretin hormones is glucagon-like-peptide- 1. It is degraded by dypeptidyl peptidase-4 (DPP- 4) minutes after secretion. The diminished "incretin effect" is recognized as a part of prediabetes, usually assosiated with IR. DPP-4, as part of the incretin system, has recently been proposed as a novel adipokine linked to IR and DPP-4 activity is higher in T1DM patients compared to healthy controls, furthermore, it correlates with the degree of IR. Tho role of the incretin system, with special emphasis on DPP-4, merits further evaluation because it might offer an insulin add- on therapeutic approach in the metabolic control of T1DM.

incretin system ; insulin resistance ; type 1 diabetes ; glucagon-like peptide-1 ; dipeptidyl peptidase-4

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