Section of Geriatric Cardiology, Department of Critical Care Medicine and Surgery, University of Florence and Azienda Ospedaliero- Universitaria Careggi, 50134 Florence, Italy.
J Endocrinol Invest. 2010 Mar;33(3):147-50. doi: 10.1007/BF03346573. Epub 2009 Sep 11.
The impaired response of glucagonlike peptide-1 (GLP-1) to meals in diabetic patients can contribute to the pathogenesis of impaired insulin secretion and post-prandial hyperglycemia. This study is aimed at the assessment of the relationship between meal-induced GLP-1 and post-prandial hyperglycemia in Type 2 diabetic patients.
Twenty-one drug-naïve Type 2 diabetic patients were studied. Blood glucose and active GLP-1 levels were measured 0, 30, 60, 90, and 120 min after a standard test meal. A continuous glucose monitoring (CGM) system was applied for the following 3 days. Nutrient intake at each meal was calculated on the basis of patients' food records. For each patient, post-prandial 120-min glucose incremental area under the curve (iAUC) was included in linear regression model exploring its relationship with total energy and carbohydrate intake, and the angular coefficient for total energy (EAC) and carbohydrate (CAC) was calculated.
GLP-1 levels peaked 30 min after the test meal. Logarithmically transformed 60-min GLP-1 iAUC showed a significant inverse correlation with glycated hemoglobin (HbA1c) (p<0.01). A significant inverse correlation of 60-min GLP-1 iAUC was also observed with EAC and CAC (both p<0.01), meaning that patients with a lower GLP-1 response to the test meal had a higher increment of post-prandial glucose for each additional unit of total energy or carbohydrate intake.
In Type 2 diabetic patients, a lower GLP-1 response to meals is associated with a higher HbA1c, and with a greater degree of meal-induced hyperglycemia, both in a meal test and during CGM in "real-life" conditions.
糖尿病患者对胰高血糖素样肽-1（GLP-1）的反应受损可能导致胰岛素分泌受损和餐后高血糖。本研究旨在评估 2 型糖尿病患者餐后 GLP-1 与餐后高血糖之间的关系。
研究了 21 例初治的 2 型糖尿病患者。在标准测试餐后 0、30、60、90 和 120 分钟测量血糖和活性 GLP-1 水平。在接下来的 3 天内应用连续血糖监测（CGM）系统。根据患者的食物记录计算每餐的营养摄入量。对于每个患者，餐后 120 分钟血糖增量曲线下面积（iAUC）被纳入线性回归模型，以探索其与总能量和碳水化合物摄入量的关系，并计算总能量（EAC）和碳水化合物（CAC）的角系数。
GLP-1 水平在测试餐后 30 分钟达到峰值。对数转换的 60 分钟 GLP-1 iAUC 与糖化血红蛋白（HbA1c）呈显著负相关（p<0.01）。60 分钟 GLP-1 iAUC 与 EAC 和 CAC 也呈显著负相关（均 p<0.01），这意味着对测试餐的 GLP-1 反应较低的患者，每增加单位总能量或碳水化合物摄入，餐后血糖升高幅度更大。
在 2 型糖尿病患者中，餐后 GLP-1 反应较低与较高的 HbA1c 以及更大程度的餐后高血糖有关，无论是在餐试还是在 CGM 期间的“真实生活”条件下。
