Glucagon-like peptide 1 and its potential in the treatment of non-insulin-dependent diabetes mellitus.
Studies examining small groups of type 2-(NIDDM) diabetic patients have shown the potential of glucagon-like peptide 1 (GLP-1) to normalize fasting hyperglycaemia. Patient characteristics determining the size of the effect have not been reported. Therefore, the results of four studies were analysed. Exogenous GLP-1 was administered i.v. or s.c. in 37 type 2-diabetic patients, age 60 +/- 8 years; BMI 28.2 +/- 5.3 kg/m2; HbA1c 10.6 +/- 1.6%; diabetes duration 10 +/- 6 years, treatment with sulfonylureas, n = 33, metformin, n = 11, acarbose, n = 3. Results were analysed using repeated measures analysis of variance and multiple regression analysis. Exogenous GLP-1 lowered fasting plasma glucose within 4-5 h from 12.8 +/- 2.5 to 5.3 +/- 1.3 mmol/l (placebo: 12.8 +/- 2.3 to 10.0 +/- 2.2; p < 0.0001 for the interaction of treatment and time). Only fasting glycaemia (p = 0.0085) and the route (i.v. vs. s.c.; p = 0.05), but not gender, age, BMI, HbA1c, diabetes duration, treatment with sulfonylureas, metformin or acarbose, were significant predictors of the plasma glucose concentrations reached after the administration of GLP-1 (variation: 3.4-8.5 mmol/l). In conclusion, GLP-1 is able to normalize plasma glucose in all type 2-diabetic patients studied. This analysis underlines the great therapeutic potential of GLP-1.
Nauck
M A
MA
Medizinische Universitätsklinik, Knappschaftskrankenhaus Bochum, Germany.
Holst
J J
JJ
Willms
B
B
D020909:Acarbose; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005934:Glucagon / Q000008:administration & dosage / Q000627:therapeutic use*; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage / Q000627:therapeutic use*; D011498:Protein Precursors / Q000008:administration & dosage / Q000627:therapeutic use*; D012044:Regression Analysis; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D014312:Trisaccharides / Q000627:therapeutic use
D020909:Acarbose; D001786:Blood Glucose; D005934:Glucagon; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D008687:Metformin; D010446:Peptide Fragments; D011498:Protein Precursors; D013453:Sulfonylurea Compounds; D014312:Trisaccharides