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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 to cause high blood sugar.1-3
Why does GLP-1 matter?

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

Native GLP-1 is associated with multiple systems in the body6-8
Select an icon to see the effects of GLP-1.
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.

How is GLP-1 Activity different in my patients with type 2 diabetes?
Because native GLP-1 is associated with various tissues and organ systems, it is directly or indirectly linked to metabolic defects in type 2 diabetes.6,10,11 Patients with type 2 diabetes have insufficient GLP-1 Activity in the pancreas.6
Insulin resistance starts developing in the early stages of type 2 diabetes12
Beta cells try to keep up but eventually can’t compensate for insulin resistance, leading to elevated blood glucose12
At the same time, incretin response (including GLP-1 Activity) declines, which contributes to beta cells' growing inability to secrete insulin3,6,10
In addition to other things, insufficient GLP-1 Activity leads to reduced insulin secretion and impaired suppression of glucagon6

Beta-cell response to GLP-1 Activity, along with many other stimuli, declines in patients with type 2 diabetes13,14


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. |
Beta-cell function declines over time
At prediabetes onset:
40%
loss in
beta-cell mass12
At T2D diagnosis:
60%
loss in
beta-cell mass12
80%
decrease in
beta-cell function10

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.
Join the conversation about GLP-1 Activity
Sign up to learn more about GLP-1 Activity.
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References:
- 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.
- 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.
- Aronoff SL, Berkowitz K, Shreiner B, Want L. Glucose metabolism and regulation: beyond insulin and glucagon. Diabetes Spectrum. 2004;17(3):183-190.
- Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018;27(4):740-756.
- Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. Cell Metab. 2013;17(6):819-837.
- 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.
- 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, Meier JJ. Incretin hormones: their role in health and disease. Diabetes Obes Metab. 2018;20:5-21. https://doi.org/10.1111/dom.13129.
- 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.
- 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.
- Leahy JL. Pathogenesis of type 2 diabetes. Arch Med Res. 2005;36(3):197-209.
- 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.
- Nauck MA, Meier JJ. GIP and GLP-1: stepsiblings rather than monozygotic twins within the incretin family. Diabetes. 2019;68(5):897-900.
- 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.