title: Dapagliflozin stimulates glucagon secretion at high glucose: experiments and mathematical simulations of human A-cells.
abstract: Glucagon is one of the main regulators of blood glucose levels and dysfunctional stimulus secretion coupling in pancreatic A-cells is believed to be an important factor during development of diabetes. However, regulation of glucagon secretion is poorly understood. Recently it has been shown that Na(+)/glucose co-transporter (SGLT) inhibitors used for the treatment of diabetes increase glucagon levels in man. Here, we show experimentally that the SGLT2 inhibitor dapagliflozin increases glucagon secretion at high glucose levels both in human and mouse islets, but has little effect at low glucose concentrations. Because glucagon secretion is regulated by electrical activity we developed a mathematical model of A-cell electrical activity based on published data from human A-cells. With operating SGLT2, simulated glucose application leads to cell depolarization and inactivation of the voltage-gated ion channels carrying the action potential, and hence to reduce action potential height. According to our model, inhibition of SGLT2 reduces glucose-induced depolarization via electrical mechanisms. We suggest that blocking SGLTs partly relieves glucose suppression of glucagon secretion by allowing full-scale action potentials to develop. Based on our simulations we propose that SGLT2 is a glucose sensor and actively contributes to regulation of glucagon levels in humans which has clinical implications.
authors.affiliation: Department of Information Engineering, University of Padua, Italy.
authors.forename: Morten Gram
authors.initials: MG
authors.lastname: Pedersen
authors.affiliation: AstraZenenca R&D Gothenburg, Dept. CVMD Bioscience, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Ahlstedt
authors.affiliation: AstraZenenca R&D Gothenburg, Dept. CVMD Bioscience, Sweden.
authors.forename: Mickaël F
authors.initials: MF
authors.lastname: El Hachmane
authors.affiliation: AstraZenenca R&D Gothenburg, Dept. CVMD Bioscience, Sweden.
authors.forename: Sven O
authors.initials: SO
authors.lastname: Göpel
mesh_terms: D000818:Animals; D001559:Benzhydryl Compounds / Q000494:pharmacology*; D002478:Cells, Cultured; D004558:Electric Stimulation; D005934:Glucagon / Q000378:metabolism*; D050416:Glucagon-Secreting Cells / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D005947:Glucose / Q000494:pharmacology*; D005960:Glucosides / Q000494:pharmacology*; D006801:Humans; D051379:Mice; D008962:Models, Theoretical; D051297:Sodium-Glucose Transporter 2 / Q000378:metabolism
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; C529054:dapagliflozin; D005934:Glucagon; D005947:Glucose