The Influence of GLP-1 on Glucose-Stimulated Insulin Secretion
Open accessAbstract
The intestinally derived hormone glucagon-like peptide 1 (GLP-1) (7-36 amide) has potent effects on glucose-mediated insulin secretion, insulin gene expression, and β-cell growth and differentiation. It is, therefore, considered a potential therapeutic agent for the treatment of type 2 diabetes. However, the dose-response relationship between GLP-1 and basal and glucose-stimulated prehepatic insulin secretion rate (ISR) is currently not known. Seven patients with type 2 diabetes and seven matched nondiabetic control subjects were studied. ISR was determined during a graded glucose infusion of 2, 4, 6, 8, and 12 mg · kg−1 · min−1 over 150 min on four occasions with infusion of saline or GLP-1 at 0.5, 1.0, and 2.0 pmol · kg−1 · min−1. GLP-1 enhanced ISR in a dose-dependent manner during the graded glucose infusion from 332 ± 51 to 975 ± 198 pmol/kg in the patients with type 2 diabetes and from 711 ± 123 to 2,415 ± 243 pmol/kg in the control subjects. The β-cell responsiveness to glucose, expressed as the slope of the linear relation between ISR and the glucose concentration, increased in proportion to the GLP-1 dose to 6 times relative to saline at the highest GLP-1 dose in the patients and 11 times in the control subjects, but it was 3 to 5 times lower in the patients with type 2 diabetes compared with healthy subjects at the same GLP-1 dose. During infusion of GLP-1 at 0.5 pmol · kg−1 · min−1 in the patients, the slope of ISR versus glucose became indistinguishable from that of the control subjects without GLP-1. Our results show that GLP-1 increases insulin secretion in patients with type 2 diabetes and control subjects in a dose-dependent manner and that the β-cell responsiveness to glucose may be increased to normal levels with a low dose of GLP-1 infusion. Nevertheless, the results also indicate that the dose-response relation between β-cell responsiveness to glucose and GLP-1 is severely impaired in patients with type 2 diabetes.
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GLP-1-based therapies magnify glucose-stimulated insulin secretion, as seen with significantly improved β-cell function in T2D following short-term infusions of GLP-1 and longer-term treatments with DPP-4 inhibitors and GLP-1 receptor agonists.
“GLP-1–based therapies magnify glucose-stimulated insulin secretion, as seen with significantly improved β-cell function in T2D following short-term infusions of GLP-1 ( 68 , 69 ) and longer-term treatments with dipeptidyl peptidase-4 inhibitors ( 70 ) and GLP-1 receptor agonists ( 71 , 72 ).”
From β-Cell Failure in Type 2 Diabetes: Postulated Mechanisms and Prospects for Prevention and Treatment (2014) · cites this paper as [69]
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- Authors
- Kjems, L. L., Holst, J. J., Vølund, A., & Madsbad, S.
- Affiliations
- University of Copenhagen (DK)
- Novo Nordisk (Denmark) (DK)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2003-02-01
- Volume
- 52
- Issue
- 2
- Pages
- 380-386
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2140978079
- Cited by
- 582
- References
- 35
- Citations by year
- 2026: 16 · 2025: 12 · 2024: 25 · 2023: 18 · 2022: 22 · 2021: 24 · 2020: 17 · 2019: 37 · 2018: 23 · 2017: 21 · 2016: 28 · 2015: 34 · 2014: 42 · 2013: 32 · 2012: 36
- FWCI
- 9.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Sundhed og Sygdom, Det Frie Forskningsråd
- Novo Nordisk
- Medical Research Council
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- glucagon-like peptide-1, glucose-stimulated insulin secretion, type 2 diabetes, dose-response relationship, beta-cell function
- MeSH terms
- Insulin Secretion, Blood Glucose, C-Peptide, Diabetes Mellitus, Type 2, Female, Glucagon, Humans, Infusions, Intravenous, Insulin, Islets of Langerhans, Kinetics, Male, Peptide Fragments, Protein Precursors, Reference Values, Glucose Clamp Technique, Area Under Curve, Glucagon-Like Peptide 1
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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