Glycaemic effects of incretins in Type 1 diabetes mellitus: a concise review, with emphasis on studies in humans.

摘要: The remission phase of Type 1 diabetes mellitus is associated with substantial recovery β-cell function and marked improvement endogenous insulin responses to meals in the early months after diagnosis, accompanied by little or no response parenteral glucose, suggesting that incretin may be important glycaemic regulation this diabetes. Preservation glucagon-like peptide-1 (GLP-1), contrasting lack stimulation secretion other known gastric inhibitory polypeptide (GIP), prompted studies exogenous GLP-1 recent-onset These showed reduction excursions ingestion mixed nutrients during intravenous infusion without administration insulin, subjects a range as demonstrated blood levels insulin-connecting peptide (CP). effects were independent CP reproduced volunteers release meals. inhibition abnormal rises glucagon, suppression human pancreatic (HPP), GLP-1. It was hypothesized major component effect attributable action inhibit emptying glucagon secretion. Studies agonists (GLP-1 exendin-4) given together established doses before meal supported hypothesis. more prolonged actions exendin-4 greater CP-negative mellitus, intensive therapy, whom delay confirmed acetaminophen ingested Side effect-free receiving continuing therapy capacity combination normalize glucose consistent dietary program volunteers, apparent increased risk hypoglycaemia within normal between-meals interval. suggested further use long-acting congeners are indicated.