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Bring GLP-1 activity into the conversation for a different perspective on an old problem

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

Experts Richard Pratley, MD and Ralph DeFronzo, MD explain more about native GLP-1 and other factors that contribute to type 2 diabetes.

Why does GLP-1 matter?

GLP-1 hormone

Glucagon-like peptide-1 (GLP-1) is a natural hormone that plays a role in maintaining normal blood glucose levels.4

See how native GLP-1 works

Healthy people
Patients with T2D
In healthy individuals, the natural hormone GLP-1 plays a role in stimulating the pancreas to secrete insulin when blood glucose rises.4,5
Patients with type 2 diabetes have inadequate GLP-1 response when blood glucose rises, which contributes, along with other things, to insufficient insulin secretion.1-3,6

Native GLP-1 is associated with multiple systems in the body6-8

Select an icon to see the effects of GLP-1.

Stimulates insulin secretion and inhibits glucagon production.4,5
(indirect action)a
Inhibits pancreatic glucagon secretion, causing reduced hepatic glucose production.
GI tract
Delays gastric emptying.
Suppresses appetite, resulting in decreased energy intake and subsequent weight loss.
Improved insulin sensitivity via weight loss may lead to improved peripheral glucose uptake.9

a“Indirect action” means that the expression of a GLP-1 receptor in that tissue has not been definitively identified or that its biologic role is not fully recognized.

Learn more about how GLP-1 works in the body


GLP-1 activity is directly or indirectly linked to metabolic defects in type 2 diabetes6,10,11

Progression of type 2 diabetes12

t2-diabetes-chartPRE-DIABETES (IFG/IGT)TYPE 2 DIABETESDIAGNOSISRelative functionDiagnosis of type 2 diabetes (y)Type 2 diabetes onsetMetabolic defects predate T2D diagnosis
t2-diabetes-chart-mobileTYPE 2 DIABETESDIAGNOSISRelative functionType 2diabetes onsetMetabolic defectspredate T2D diagnosisDiagnosis of type 2 diabetes (y)
Insulin resistance starts developing even before type 2 diabetes is diagnosed13
Beta cells try to keep up but eventually can’t compensate for insulin resistance, leading to elevated blood glucose13
This isn’t the full picture though—beta-cell response, along with many other stimuli, declines10
legend-resistance Insulin resistance
legend-secretion Insulin secretion
beta-cell-function Beta-cell function
back to top

Natural History of Type 2 Diabetes ©2010, International Diabetes Center at Park Nicollet, Minneapolis, MN. Used with permission.
IFG=impaired fasting glucose.
IGT=impaired glucose tolerance.

The decline in beta-cell response to GLP-1 activity may occur early and precede the onset of type 2 diabetes3,11,13,14

At prediabetes onset:


loss in
beta-cell mass13

At T2D diagnosis:


loss in
beta-cell mass13


decrease in
beta-cell function10


Hear more about native GLP-1 and other factors that contribute to T2D from the experts

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

Talk with patients about GLP-1 activity and how it may factor into their type 2 diabetes

You cover a number of topics in your conversations with patients with type 2 diabetes. Make sure GLP-1 activity is one of them.

Talk with patients about GLP-1 activity and how it may factor into their type 2 diabetes

You cover a number of topics in your conversations with patients with type 2 diabetes. Make sure GLP-1 activity is one of them.

Help us provide better resources for you and your patients by telling us about the conversations you have with patients about GLP-1 activity.

Join the conversation about GLP-1 activity

Sign up to learn more about GLP-1 activity.

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Hear from your peers in a webinar

Join us for a 5-part webinar series focused on type 2 diabetes, including the role of native GLP-1. Each program includes a disease state education presentation followed by a question and answer session.

Module 1

The growing diabetes epidemic: Why we need to care about the burden of T2D

Module 2

Beta-cell dysfunction, insulin resistance, and insufficient GLP-1 activity in T2D

Module 3

Evaluating research: The role of endogenous GLP-1

Module 4

Insufficient GLP-1 activity in T2D

Module 5

Should we be thinking about diabetes differently?

Visit to learn more and register

This program is sponsored by Novo Nordisk.

This is an Industry-Sponsored education series; it will not be certified for continuing medical education credit.

In accordance with the PhRMA Code on Interactions with Healthcare Professionals, attendance at this educational program is limited to health care professionals. Accordingly, attendance by guests or spouses is not appropriate and cannot be accommodated.


  1. 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.
  2. 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.
  3. 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.
  4. Aronoff SL, Berkowitz K, Shreiner B, Want L. Glucose metabolism and regulation: beyond insulin and glucagon. Diabetes Spectrum. 2004;17(3):183-190.
  5. Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018;27(4):740-756.
  6. Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. Cell Metab. 2013;17(6):819-837.
  7. Korner M, Stöckli M, Waser B, Reubi JC. GLP-1 receptor expression in human tumors and human normal tissues: potential for in vivo targeting. J Nucl Med. 2007;48(5):736-743.
  8. 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.
  9. Nauck MA, Meier JJ. Incretin hormones: their role in health and disease. Diabetes Obes Metab. 2018;20:5-21.
  10. DeFronzo RA. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009;58(4):773-795.
  11. Holst JJ, Knop FK, Vilsbøll T, Krarup T, Madsbad S. Loss of incretin effect is a specific, important, and early characteristic of type 2 diabetes. Diabetes Care. 2011;34(suppl 2):S251-S257.
  12. Simonson G, Cuddihy R, Reader D, Bergenstal R. International diabetes center treatment of type 2 diabetes glucose algorithm. Diabetes Manage. 2011:1(2):175-189.
  13. Leahy JL. Pathogenesis of type 2 diabetes. Arch Med Res. 2005;36(3):197-209.
  14. 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.