Vol 58, No 6 (2007)
Review paper
Submitted: 2013-02-15
Published online: 2007-11-21
Incretin hormones in the treatment of type 2 diabetes. Part I: Influence of insulinotropic gut-derived hormones (incretins) on glucose metabolism
Beata Matuszek, Monika Lenart-Lipińska, Andrzej Nowakowski
Endokrynol Pol 2007;58(6):522-528.
Vol 58, No 6 (2007)
Review Article
Submitted: 2013-02-15
Published online: 2007-11-21
Abstract
Insulinotropic gut-derived hormones (incretins) play a significant role in the regulation of glucose homeostasis in healthy
subjects and are responsible for 50-70% of insulin response to a meal. The main mediators of the incretin effect are glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). However, in patients with type 2 diabetes
the effect of incretins action is to a large extent impaired, which seems to explain disturbed secretional activity of β cells in
pancreatic islets. Detailed analysis of incretin defect proved that GIP secretion remains within physiological limits, whereas
GLP-1 secretion is significantly decreased. Nevertheless, GLP-1 insulinotropic effect is preserved and GIP effect is significantly
impaired. In consequence, substitutional GLP-1 administration aiming at the reduction of its deficiency, seems to be logical
therapeutic management, because despite a physiologically retained quantity response from GIP, resistance to this peptide is
frequently found. Therefore, particularly promising are the results of clinical studies with the use of GLP-1 analogues , GLP-1
receptors activation, as well as the inhibitors of dipeptidyl peptidase-IV (DPP IV), the enzyme responsible for incretin proteolysis,
which restores the proper function of the intestinal-pancreatic axis in subjects with type 2 diabetes and creates new
possibilities of a glycaemia reducing therapy and improvement in quality of life in this group of patients.
Abstract
Insulinotropic gut-derived hormones (incretins) play a significant role in the regulation of glucose homeostasis in healthy
subjects and are responsible for 50-70% of insulin response to a meal. The main mediators of the incretin effect are glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). However, in patients with type 2 diabetes
the effect of incretins action is to a large extent impaired, which seems to explain disturbed secretional activity of β cells in
pancreatic islets. Detailed analysis of incretin defect proved that GIP secretion remains within physiological limits, whereas
GLP-1 secretion is significantly decreased. Nevertheless, GLP-1 insulinotropic effect is preserved and GIP effect is significantly
impaired. In consequence, substitutional GLP-1 administration aiming at the reduction of its deficiency, seems to be logical
therapeutic management, because despite a physiologically retained quantity response from GIP, resistance to this peptide is
frequently found. Therefore, particularly promising are the results of clinical studies with the use of GLP-1 analogues , GLP-1
receptors activation, as well as the inhibitors of dipeptidyl peptidase-IV (DPP IV), the enzyme responsible for incretin proteolysis,
which restores the proper function of the intestinal-pancreatic axis in subjects with type 2 diabetes and creates new
possibilities of a glycaemia reducing therapy and improvement in quality of life in this group of patients.
Keywords
type 2 diabetes; incretin effect; GLP-1; GIP
Title
Incretin hormones in the treatment of type 2 diabetes. Part I: Influence of insulinotropic gut-derived hormones (incretins) on glucose metabolism
Journal
Endokrynologia Polska
Issue
Vol 58, No 6 (2007)
Article type
Review paper
Pages
522-528
Published online
2007-11-21
Page views
694
Article views/downloads
4988
Bibliographic record
Endokrynol Pol 2007;58(6):522-528.
Keywords
type 2 diabetes
incretin effect
GLP-1
GIP
Authors
Beata Matuszek
Monika Lenart-Lipińska
Andrzej Nowakowski
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