Glucose kinetics: An update and novel insights into its regulation by glucagon and GLP-1

Amalia Gastaldelli, Melania Gaggini, Ralph A Defronzo

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Purpose of review Glucagon and GLP-1 share the same origin (i.e., proglucagon); primarily GLP-1 is generated from intestinal L-cells and glucagon from pancreatic α-cell, but intestinal glucagon and pancreatic GLP-1 secretion is likely. Glucose kinetics are tightly regulated by pancreatic hormones insulin and glucagon, but other hormones, including glucagon-like peptide-1 (GLP-1), also play an important role. The purpose of this review is to describe the recent findings on the mechanisms by which these two hormones regulate glucose kinetics. Recent findings Recent findings showed new important mechanisms of action of glucagon and GLP-1 in the regulation of glucose metabolism. Knock out of glucagon receptors protects against hyperglycemia without causing hypoglycemia. GLP-1 not only stimulates insulin secretion, but it has also an independent effect on the liver and inhibits glucose production. Moreover, when coinfused with glucagon, GLP-1 limits the hyperglycemic effects. Both hormones have also central effects on gastric emptying (delayed), intestinal motility (reduced), and satiety (increased). Summary The implications of these findings are very important for the management of type 2 diabetes given that GLP-1 receptor agonist are currently approved for the treatment of hyperglycemia and glucagon receptor antagonists and GLP-1/glucagon dual agonists are under development.

Original languageEnglish (US)
Pages (from-to)300-309
Number of pages10
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume20
Issue number4
DOIs
Publication statusPublished - Jul 1 2017

    Fingerprint

Keywords

  • cerebral glucose metabolism
  • endogenous glucose production
  • glucagon
  • glucagon like peptide 1
  • hepatic glucose metabolism
  • insulin resistance
  • non alcoholic fatty liver disease
  • peripheral glucose metabolism

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this