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The dynamic incretin adaptation and type 2 diabetes.

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Impaired regulation of the incretin effect in patients with type 2 diabetes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Holst, Jens J. Vilsbøll, Tina Knop, Filip K. Vestergaard, Henrik Bagger, Jonatan I. Lund, Asger
Description	Country affiliation: Denmark Author Affiliation: Bagger JI ( Diabetes Research Division, Department of Internal Medicine F, Gentofte Hospital, University of Copenhagen, DK-2900 Copenhagen, Denmark.)
Abstract	OBJECTIVE: In healthy subjects, the incretin effect during an oral glucose tolerance test increases with the size of glucose load, resulting in similar glucose excursions independently of the glucose loads. Whether patients with type 2 diabetes mellitus (T2DM) are able to regulate their incretin effect is unknown. RESEARCH DESIGN AND METHODS: Incretin effect was measured over 6 d by means of three 4-h oral glucose tolerance test with increasing glucose loads (25, 75, and 125 g) and three corresponding isoglycemic iv glucose infusions in eight patients with T2DM [fasting plasma glucose, mean 7.7 (range 7.0-8.9) mM; glycosylated hemoglobin, 7.0% (6.2-8.4%)] and eight matched healthy control subjects [fasting plasma glucose, 5.3 (4.8-5.7) mM; glycosylated hemoglobin, 5.4% (5.0-5.7%)]. RESULTS: Patients with T2DM exhibited higher peak plasma glucose in response to increasing oral glucose loads, whereas no differences in peak plasma glucose values among control subjects were observed. The incretin effect was significantly (P < 0.003) lower in patients with T2DM (0 ± 7, 11 ± 9, and 36 ± 5%) as compared with control subjects (36 ± 5, 53 ± 6, and 65 ± 6%). Equal and progressively delayed gastric emptying due to the increasing loads was found in both groups. Incretin hormone responses were similar. CONCLUSIONS: Up-regulation of the incretin effect in response to increasing oral glucose loads seems to be crucial for controlling glucose excursions in healthy subjects. Patients with T2DM are characterized by an impaired capability to regulate their incretin effect, which may contribute to the exaggerated glucose excursions after oral ingestion of glucose in these patients.
ISSN	0021972X
e-ISSN	19457197
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	3
Volume Number	96
Language	English
Publisher	Oxford University Press
Publisher Date	2011-03-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Diabetes Mellitus, Type 2 Metabolism Incretins Acetaminophen Pharmacokinetics Analgesics, Non-narcotic Area Under Curve Blood Glucose C-peptide Blood Gastric Emptying Physiology Gastric Inhibitory Polypeptide Glucagon-like Peptide 1 Glucose Glucose Tolerance Test Hemoglobin A, Glycosylated Insulin Secretion Insulin-secreting Cells Research Support, Non-u.s. Gov't Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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