Bring GLP-1 Activity into the conversation to help your T2D patients better understand their disease
GLP-1 Activity is an element of type 2 diabetes and should be included when talking with your patients in order to help them understand what is happening in their body when it responds to high blood sugar.1-3
GLP-1=glucagon-like peptide-1
Get the peer perspective:
Experts Richard Pratley, MD, and Ralph DeFronzo, MD, explain more about native GLP‑1 and other factors that contribute to type 2 diabetes.
Understanding the role of GLP‑1 in type 2 diabetes
Richard Pratley, MD
The progressive nature of type 2 diabetes: beta-cell dysfunction and apoptosis
Ralph DeFronzo, MD
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GLP-1 Activity in a healthy person:
Sufficient signals to lower blood glucose levels1-3
GLP-1 is released from the gut in response to food intake.3
Experimental models of diabetes have shown that the GLP-1 Activity signal, among other signals,* helps to lower blood glucose and regulate metabolic responses by facilitating the communications among organs.1-3
*Additional signals include increased plasma concentrations of amino acids such as arginine, leucine, and lysine, as well as parasympathetic stimulation via the vagus nerve.3
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GLP-1 Activity in type 2 diabetes:
Insufficient signals to lower blood glucose levels12-14
The response to food is no longer appropriate because the GLP-1 Activity signal strength is inadequate. This contributes to, among other things, inadequate insulin secretion from the pancreas.12-15
Subpar GLP-1 Activity may be directly or indirectly linked to metabolic defects in type 2 diabetes.4
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GLP-1 RAs help boost GLP-1 Activity1,4,16
GLP-1 RAs mimic native GLP-1, inducing GLP-1 Activity in the pancreas, liver, and stomach1,4,16
Like native GLP-1, GLP-1 RAs directly stimulate GLP-1 receptors. Boosted GLP-1 Activity helps ensure the communications are received and acted upon.1,4,17
GLP-1 RAs=glucagon-like peptide-1 receptor agonists.
The role of GLP-1 Activity and GLP-1 RAs
In patients with type 2 diabetes,
GLP-1 Activity is insufficient to signal the lowering of blood glucose levels12-14
GLP-1 RAs mimic native GLP-1, inducing GLP-1 Activity in the pancreas, liver, and stomach1,4,17
Learn more about how GLP-1 works in the body
Understanding the role of GLP-1 in type 2 diabetes
Richard Pratley, MD
Diabetes Program Lead
AdventHealth Translational Research Institute for Metabolism and Diabetes
Orlando, Florida
The progressive nature of type 2 diabetes: beta-cell dysfunction and apoptosis
Ralph DeFronzo, MD
Professor of Medicine
Chief, Diabetes Division
University of Texas Health Science Center
Texas Diabetes Institute
San Antonio, Texas
Stay in the conversation about GLP-1 Activity
References:
- Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018;27(4):740-756.
- Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology. 2007;132(6):2131-2157.
- Aronoff SL, Berkowitz K, Shreiner B, Want L. Glucose Metabolism and Regulation: Beyond Insulin and Glucagon. Diabetes Spectrum. 2004;17(3):183-190.
- Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanism of incretin hormone action. Cell Metab. 2013;17(6):819-837.
- Muscogiuri G, DeFronzo RA, Gastaldelli A, Holst JJ. Glucagon-like peptide-1 and the central/peripheral nervous system: crosstalk in diabetes. Trends Endocrinol Metab. 2017;28(2):88-103.
- Nauck MA, Quast DR, Wefers J, Pfeiffer AFH. The evolving story of incretins (GIP and GLP-1) in metabolic and cardiovascular disease: a pathophysiological update. Diabetes Obes Metab. 2021. [in press].
- Kimura T, Obata A, Shimoda M, et al. Down-regulation of vascular GLP-1 receptor expression in human subjects with obesity. Sci Rep. 2018;8(1):10644.
- Müller TD, Finan B, Bloom SR, et al. Glucagon-like peptide-1 (GLP-1). Mol Metab. 2019;30:72-130.
- Li J, Zheng J, Wang S, Lau HK, Fathi A, Wang Q. Cardiovascular benefits of native GLP-1 and its metabolites: an indicator for GLP-1-therapy strategies. Front Physiol. 2017;8:15.
- Druce MR, Small CJ, Bloom SR. Minireview: gut peptides regulating satiety. Endocrinology. 2004;145(6):2660-2665.
- Kanoski SE, Hayes MR, Skibicka KP. GLP-1 and weight loss: unraveling the diverse neural circuitry. Am J Physiol Regul Integr Comp Physiol. 2016;310(10):R885-R895.
- Herzberg-Schäfer S, Heni M, Stefan N, Häring H-U, Fritsche A. Impairment of GLP1-induced insulin secretion: role of genetic background, insulin resistance and hyperglycaemia. Diabetes Obes Metab. 2012;14(suppl 3):85-90.
- Kjems LL, Holst JJ, Vølund A, Madsbad S. The influence of GLP-1 on glucose-stimulated insulin secretion: effects on beta-cell sensitivity in type 2 and nondiabetic subjects. Diabetes. 2003;52(2):380-386.
- Calanna S, Christensen M, Holst JJ, et al. Secretion of glucagon-like peptide-1 in patients with type 2 diabetes mellitus: systematic review and meta-analyses of clinical studies. Diabetologia. 2013;56(5):965-972.
- Højberg PV, Vilsbøll T, Rabøl R, et al. Four weeks of near-normalisation of blood glucose improves the insulin response to glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide in patients with type 2 diabetes. Diabetologia. 2009;52(2):199-207.
- Hinnen D. Glucagon-like peptide 1 receptor agonist for type 2 diabetes. Diabetes Spectrum. 2017;30(3):202-210.
- Wick A, Newlin K. Incretin-based therapies: therapeutic rationale and pharmacological promise for type 2 diabetes. J Am Acad Nurse Pract. 2009;21(suppl 1):623-630.
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