title: The effect of exogenous glucose-dependent insulinotropic polypeptide in combination with glucagon-like peptide-1 on glycemia in the critically ill.
abstract: OBJECTIVE
  Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) have additive insulinotropic effects when coadministered in health. We aimed to determine whether GIP confers additional glucose lowering to that of GLP-1 in the critically ill.
  
  
  METHODS
  Twenty mechanically ventilated critically ill patients without known diabetes were studied in a prospective, randomized, double-blind, crossover fashion on 2 consecutive days. Between T0 and T420 minutes, GLP-1 (1.2 pmol/kg·min(-1)) was infused intravenously with either GIP (2 pmol/kg·min(-1)) or 0.9% saline. Between T60 and T420 minutes, nutrient liquid was infused into the small intestine at 1.5 kcal/min.
  
  
  RESULTS
  Adding GIP did not alter blood glucose or insulin responses to small intestinal nutrient. GIP increased glucagon concentrations slightly before nutrient delivery (P=0.03), but not thereafter.
  
  
  CONCLUSIONS
  The addition of GIP to GLP-1 does not result in additional glucose-lowering or insulinotropic effects in critically ill patients with acute-onset hyperglycemia.
authors.affiliation: Corresponding author: Adam M. Deane, adam.deane@adelaide.edu.au.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Lee
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Fraser
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Chapman
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Sundararajan
authors.forename: Mahesh M
authors.initials: MM
authors.lastname: Umapathysivam
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Summers
authors.forename: Antony V
authors.initials: AV
authors.lastname: Zaknic
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Rayner
authors.forename: Juris J
authors.initials: JJ
authors.lastname: Meier
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
authors.forename: Adam M
authors.initials: AM
authors.lastname: Deane
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects*; D016638:Critical Illness; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005749:Gastric Inhibitory Polypeptide / Q000008:administration & dosage / Q000627:therapeutic use*; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1