肠道葡萄糖类-1 在降血糖对抗调节中用于1型糖尿病管理
Ke-Xin Zhang1, Cheng-Xia Kan1, Yu-Qun Wang1
1Department of Endocrinology and Metabolism, The Affiliated Hospital of Shandong Second Medical University, Weifang 261031, Shandong Province, China.
World journal of diabetes
|December 16, 2024
概括
1型糖尿病 (T1D) 管理面临的挑战是低血糖症由于受损的对抗调节. 肠道葡萄糖类-1 (GLP-1) 的升高进一步阻碍了身体恢复血糖水平的能力.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 免疫学 免疫学 免疫学
背景情况:
- 1型糖尿病 (T1D) 涉及胰腺β细胞的自身免疫破坏,需要胰岛素治疗.
- 低血糖是T1D的主要并发症,由缺陷的逆调节激素反应加剧.
- 低血糖相关的自主性衰竭可以在反复出现低血糖事件后发展.
研究的目的:
- 突出提高肠道葡萄糖类-1 (GLP-1) 在降低T1D中对调节性激素分泌的作用.
- 讨论GLP-1对葡萄糖平衡和低血糖管理的非增增蛋白效应的影响.
- 倡导仔细考虑基于GLP-1的T1D治疗方法.
主要方法:
- 审查目前关于GLP-1生理学的研究及其对T1D反调节的影响.
- 分析高GLP-1水平影响葡萄糖和上腺素分泌的机制.
- 对T1D治疗策略的临床影响的讨论.
主要成果:
- 发现肠道GLP-1水平升高会抑制葡萄糖和上腺素的分泌.
- 这种抑制有助于在T1D中低血糖期间对抗调节反应受损.
- GLP-1的作用超出了其已知的隐形蛋白效应,影响葡萄糖防御机制.
结论:
- GLP-1在1型糖尿病中观察到的低血糖逆调的受损中发挥着重要作用.
- 在考虑为T1D患者提供基于GLP-1的疗法时,均衡的方法至关重要.
- 需要进一步的研究,以了解GLP-1机制,并制定干预措施,以改善对监管功能和患者安全.
相关概念视频
Glucagon-like Receptor Agonists
297
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
297
Hypoglycemia and Glucagon
150
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
150
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
1.1K
The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are...
Insulin and C-peptide are...
1.1K
Hormones Regulating Blood Glucose
3.1K
Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...
In addition to accelerating glucose uptake and utilization, insulin has...
3.1K
Oral Hypoglycemic Agents: Glinides
136
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
136
Dipeptidyl Peptidase 4 Inhibitors
167
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
167


