1. Reduced incretin effect in type 2 diabetes: cause or consequence of the diabetic state?
- Author
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Knop, Filip K., Vilsboll, Tina, Hojberg, Patricia V., Larsen, Steen, Madsbad, Sten, Volund, Aage, Holst, Jens J., and Krarup, Thure
- Subjects
Insulin -- Health aspects -- Research ,Type 2 diabetes -- Health aspects -- Research ,Glucagon -- Research -- Health aspects ,Health ,Research ,Health aspects - Abstract
We aimed to investigate whether the reduced incretin effect observed in patients with type 2 diabetes is a primary event in the pathogenesis of type 2 diabetes or a consequence of the diabetic state. Eight patients with chronic pancreatitis and secondary diabetes (A1C mean [range] of 6.9% [6.2-8.0]), eight patients with chronic pancreatitis and normal glucose tolerance (NGT; 5.3 [4.9-5.7]), eight patients with type 2 diabetes (6.9 [6.2-8.0]); and eight healthy subjects (5.5 [5.1-5.8]) were studied. Blood was sampled over 4 h on 2 separate days after a 50-g oral glucose load and an isoglycemic intravenous glucose infusion, respectively. The incretin effect (100% x [β-cell secretory response to oral glucose tolerance test--intravenous β-cell secretory response]/β-cell secretory response to oral glucose tolerance test) was significantly (P < 0.05) reduced (means ± SE) in patients with chronic pancreatitis and secondary diabetes (31 ± 4%) compared with patients with chronic pancreatitis and NGT (68 ± 3) and healthy subjects (60 ± 4), respectively. In the type 2 diabetes group, the incretin effect amounted to 36 ± 6%, significantly (P < 0.05) lower than in chronic pancreatitis patients with NGT and in healthy subjects, respectively. These results suggest that the reduced incretin effect is not a primary event in the development of type 2 diabetes, but rather a consequence of the diabetic state., The phenomenon that oral glucose elicits a higher insulin response than intravenous glucose at identical plasma glucose (PG) profiles (isoglycemia) is called the incretin effect. The incretin effect is conveyed [...]
- Published
- 2007