GLP-1 EFFECTS ON INSULIN SECRETION AND SENSITIVITY IN TYPE II DIABETES

胰高血糖素样肽-1(GLP-1)是一种天然产生的多肽类激素，由进食后的空肠和回肠分泌。它是人类最有效的胰岛素促进剂，即它与葡萄糖协同作用，增加胰岛素的分泌。与胰岛素在糖耐量状态下的作用不同，GLP-1已被证明在II型糖尿病患者中具有促胰岛素作用，不同于另一种众所周知的胰岛素素，即葡萄糖依赖的促胰岛素肽(GIP)。此外，一些研究表明，GLP-1与胰岛素类似，具有独立的作用，即增强葡萄糖摄取的能力，而不依赖于它的胰岛素效应。因此，GLP-1有可能成为II型糖尿病状态的治疗剂。我们将给II型糖尿病患者皮下注射GLP-1，为期48小时，检查输注前后的胰岛素分泌和敏感性，以回应通过钳夹技术输送的葡萄糖。我们之前进行了短暂(1小时)的静脉输注GLP-1，但未能显示出胰外效应。更长时间的输注应该可以决定性地证明GLP-1是否确实有任何胰腺外效应。仅限核心实验室；没有住院日或门诊就诊。

Glucagon-like peptide-1 (GLP-1) is a naturally produced peptide hormone which is secreted from the jejunum and ilium following food intake. It is the most potent insulinotropic agent in humans, i.e., it synergizes with glucose to augment insulin secretion. In contrast to the effects of incretins in glucose tolerant states, GLP-1 has been shown to be insulinotropic in Type II diabetic subjects, unlike the other well-known incretin, glucose-dependent insulinotropic peptide (GIP). In addition, several studies have implicated an independent role for GLP-1 similar to that of insulin, i.e., the ability to enhance glucose uptake independent of its insulinotropic effect. Thus GLP-1 has the potential to be a therapeutic agent in Type II diabetic states. We will deliver GLP-1 subcutaneously to Type II diabetic subjects for 48 hours, checking insulin secretion and sensitivity, before and after the infusions, in response to glucose delivered by way of clamp technology We previously performed a short (one hour) infusion of GLP-1 intraveneously and were not able to demonstrate extrapancreatic effects. A longer infusion should decisively demonstrate whether there are in fact any extrapancreatic effects of the GLP-1. CORE LABORATORY ONLY; NO INPATIENT DAYS OR OUTPATIENT VISITS.