Naslov
Relationship between postprandial glucagon-like peptide 1, glucagon levels and short and long- acting insulin requirement in C-peptide negative type 1 diabetic patients

Autori
Zibar, Karin ; Bulum, Tomislav ; Blaslov, Kristina ; Duvnjak, Lea

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Diabetes 2013 ; 62 (Suppl. 1): A 261-A261 / - , 2013

Skup
73rd Scientific Sessions of American Diabetes Association

Mjesto i datum
Chicago (IL), Sjedinjene Američke Države, 21.06.2013. - 25.06.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
glucagon-like peptide 1; glucagon; type 1 diabetes

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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