1. GIP Does Not Potentiate the Antidiabetic Effects of GLP-1 in Hyperglycemic Patients With Type 2 Diabetes
- Author
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Mentis, Nikolaos Vardarli, Irfan Koethe, Lars D. Holst, Jens J. Deacon, Carolyn F. Theodorakis, Michael Meier, Juris J. and Nauck, Michael A. and Mentis, Nikolaos Vardarli, Irfan Koethe, Lars D. Holst, Jens J. Deacon, Carolyn F. Theodorakis, Michael Meier, Juris J. and Nauck, Michael A.
- Abstract
OBJECTIVE-The incretin glucagon-like peptide 1 (GLP-1) exerts insulinotropic activity in type 2 diabetic patients, whereas glucose-dependent insulinotropic polypeptide (GIP) no longer does. We studied whether GIP can alter the insulinotropic or glucagonostatic activity of GLP-1 in type 2 diabetic patients. RESEARCH DESIGN AND METHODS-Twelve patients with type 2 diabetes (nine men and three women; 61 +/- 10 years; BMI 30.0 +/- 3.7 kg/m(2); HbA(1c) 7.3 +/- 1.5%) were studied. In randomized order, intravenous infusions of GLP-1(7-36)-amide (1.2 pmol . kg(-1) . min(-1)), GIP (4 pmol . kg(-1) . min(-1)), GLP-1 plus GIP, and placebo were administered over 360 min after an overnight fast (>= 1 day wash-out period between experiments). Capillary blood glucose, plasma insulin, C-peptide, glucagon, GIP, GLP-1, and free fatty acids (FFA) were determined. RESULTS-Exogenous GLP-1 alone reduced glycemia from 10.3 to 5.1 +/- 0.2 mmol/L. Insulin secretion was stimulated (insulin, C-peptide, P < 0.0001), and glucagon was suppressed (P = 0.009). With GIP alone, glucose was lowered slightly (P = 0.0021); insulin and C-peptide were stimulated to a lesser degree than with GLP-1 (P < 0.001). Adding GIP to GLP-1 did not further enhance the insulinotropic activity of GLP-1 (insulin, P = 0.90; C-peptide, P = 0.85). Rather, the suppression of glucagon elicited by GLP-1 was antagonized by the addition of GIP (P = 0.008). FFA were suppressed by GLP-1 (P < 0.0001) and hardly affected by GIP (P = 0.07). CONCLUSIONS-GIP is unable to further amplify the insulinotropic and glucose-lowering effects of GLP-1 in type 2 diabetes. Rather, the suppression of glucagon by GLP-1 is antagonized by GIP. Diabetes 60:1270-1276, 2011
- Published
- 2011