The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?

Aulinger, Benedikt A.; Vahl, Torsten P.; Prigeon, Ron L.; D'Alessio, David A.; Elder, Deborah A.

doi:10.1152/ajpendo.00496.2015

Cited by 24Pancreatic function and diabetesDiabetes Treatment and ManagementDiabetes Management and Research

The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?

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Aulinger, Benedikt A., Vahl, Torsten P., Prigeon, Ron L., D'Alessio, David A., Elder, Deborah A.·2016·American Journal of Physiology-Endocrinology and Metabolism

DOI 10.1152/ajpendo.00496.2015PMC PMC4867309

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Abstract

The incretin effect reflects the actions of enteral stimuli to promote prandial insulin secretion. Impairment of this measure has been proposed as an early marker of β-cell dysfunction and described in T2D, IGT, and even obesity without IGT. We sought to determine the effects of obesity and diabetes on the incretin effect in young subjects with short exposures to metabolic abnormalities and a few other confounding medical conditions. Subjects with T2D ( n = 10; 18.0 ± 0.4 yr) or NGT, either obese ( n = 11; 17.7 ± 0.4 yr) or lean ( n = 8; 26.5 ± 2.3 yr), had OGTT and iso-iv. The incretin effect was calculated as the difference in insulin secretion during these tests and was decreased ∼50% in both the NGT-Ob and T2D subjects relative to the NGT-Ln group. The T2D group had impaired glucose tolerance and insulin secretion during the OGTT, whereas the lean and obese NGT subjects had comparable glucose excursions and β-cell function. During the iso-iv test, the NGT-Ob subjects had significantly greater insulin secretion than the NGT-Ln and T2D groups. These findings demonstrate that in young subjects with early, well-controlled T2D the incretin effect is reduced, similar to what has been described in diabetic adults. The lower incretin effect calculated for the obese subjects with NGT is driven by a disproportionately greater insulin response to iv glucose and does not affect postprandial glucose regulation. These findings confirm that the incretin effect is an early marker of impaired insulin secretion in persons with abnormal glucose tolerance but suggest that in obese subjects with NGT the incretin effect calculation can be confounded by exaggerated insulin secretion to iv glucose.

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The study only tested young and healthy adults and did not confirm results in obese subjects or patients with impaired glucose metabolism.
“Also, we only tested young and healthy adults and did not confirm our results in obese subjects or patients with impaired glucose metabolism (18, 37).”
From Assessment of the incretin effect in healthy subjects: concordance between clamp and OGTT methods (2023) · cites this paper as [18]

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Incretin hormones and type 2 diabetes
Nauck, M. A., & Müller, T. D. (2023) · Diabetologia · doi:10.1007/s00125-023-05956-x · Cited by 190 · see citing works
Assessment of the incretin effect in healthy subjects: concordance between clamp and OGTT methods
Aulinger, B. A., & D’Alessio, D. A. (2023) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00104.2022 · Cited by 6 · see citing works
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Authors: Aulinger, B. A., Vahl, T. P., Prigeon, R. L., D'Alessio, D. A., & Elder, D. A.
Affiliations: University of Cincinnati (US)
Baltimore VA Medical Center (US)
Department of Medicine, University of Cincinnati, Cincinnati, Ohio;
Cincinnati Children's Hospital Medical Center (US)
ORCID: Aulinger, Benedikt A.
Vahl, Torsten P.
Elder, Deborah A.
Venue: American Journal of Physiology-Endocrinology and Metabolism
Publisher: American Physiological Society
Published: 2016-05-01
Volume: 310
Issue: 9
Pages: E774-E781
ISSN: 0193-1849 (ISSN-L)
1522-1555
DOI: 10.1152/ajpendo.00496.2015
PMC: PMC4867309
OpenAlex: W2302107750
Cited by: 24
References: 43
Citations by year: 2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 1
FWCI: 2.21
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (K23DK070775)
U.S. Department of Veterans Affairs (VA)
Topics: Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: incretin effect, type 2 diabetes, obesity, adolescents, beta-cell dysfunction, insulin secretion, impaired glucose tolerance, oral glucose tolerance test, intravenous glucose tolerance test, postprandial glucose regulation
MeSH terms: Insulin Secretion, Adolescent, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Male, Obesity, Case-Control Studies, Incretins, Young Adult

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The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?

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