Cited by 243Diabetes Treatment and ManagementPancreatic function and diabetesRegulation of Appetite and Obesity

The expanding incretin universe: from basic biology to clinical translation

Open access
Drucker, Daniel J., Holst, Jens J.·2023·Diabetologia

Abstract

Incretin hormones, principally glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1(GLP-1), potentiate meal-stimulated insulin secretion through direct (GIP + GLP-1) and indirect (GLP-1) actions on islet β-cells. GIP and GLP-1 also regulate glucagon secretion, through direct and indirect pathways. The incretin hormone receptors (GIPR and GLP-1R) are widely distributed beyond the pancreas, principally in the brain, cardiovascular and immune systems, gut and kidney, consistent with a broad array of extrapancreatic incretin actions. Notably, the glucoregulatory and anorectic activities of GIP and GLP-1 have supported development of incretin-based therapies for the treatment of type 2 diabetes and obesity. Here we review evolving concepts of incretin action, focusing predominantly on GLP-1, from discovery, to clinical proof of concept, to therapeutic outcomes. We identify established vs uncertain mechanisms of action, highlighting biology conserved across species, while illuminating areas of active investigation and uncertainty that require additional clarification.

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  • Several incretin-based peptide therapies have been reported to offer clinically significant benefits to reduce liver fat, improve bone quality and counter some neurodegenerative disorders.

    “Several incretin-based peptide therapies have been reported to offer clinically significant benefits to reduce liver fat, improve bone quality and counter some neurodegenerative disorders [82].”

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Authors
Drucker, D. J., & Holst, J. J.
Affiliations
  • Mount Sinai Hospital (CA)
  • University of Copenhagen (DK)
Corresponding author
Drucker, Daniel J.
Venue
Diabetologia
Published
2023-03-28
Volume
66
Issue
10
Pages
1765-1779
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
OpenAlex
W4361190766
Cited by
243
References
174
Citations by year
2026: 57 · 2025: 98 · 2024: 70 · 2023: 18
FWCI
8.73
Type
journal article
Language
en
Open access
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
Funders
CIHR (154321)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
incretins, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide, GLP-1 receptor, GIP receptor, insulin secretion, beta-cell function, glucagon secretion, type 2 diabetes, obesity, incretin-based therapy, anorectic effect, glucoregulation
MeSH terms
Biology, Diabetes Mellitus, Type 2, Gastric Inhibitory Polypeptide, Humans, Glucagon-Like Peptide 1, Incretins

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