Willms B, Idowu K, Holst J J, Creutzfeldt W, Nauck M A
Fachklinik für Diabetes und Stoffwechselkrankheiten, Bad Lauterberg, Germany.
Exp Clin Endocrinol Diabetes. 1998;106(2):103-7. doi: 10.1055/s-0029-1211959.
GLP-1 (7-36 amide) normalizes fasting plasma glucose in NIDDM patients. It was the aim to study the effect of overnight intravenous GLP-1 (7-36 amide) on the following 24 h-glucose profiles. Ten NIDDM patients (7 female, 3 male; age 62 +/- 4 y., BMI (Body-Mass-Index) 29.6 +/- 3.9 kg/m2, duration 10 +/- 7 y., HbA1c 10.9 +/- 1.3% (normal 4.0-6.1%), treated with glibenclamide and/or metformin) were studied on two occasions in random order: Either GLP-1 (7-36 amide) (Saxon Biochemicals, Hannover, FRG, 1 pmol x kg(-1) x min(-1)) or placebo (0.9% NaCl with 1% human serum albumin, Behringwerke, Marburg, FRG) were infused intravenously from 22:00 to 7:00 (9 h) and plasma glucose profiles were obtained during the GLP-1 infusion and the following 24 hours. GLP-1 (7-36 amide) (plasma concentration 110 +/- 12 pmol/l) raised plasma C-peptide concentrations (p = 0.0005), suppressed glucagon (p = 0.01) and lowered plasma glucose to 5.5 +/- 0.6 and 6.3 +/- 0.4 mmol/l at 3:00 and 7:00 a.m. (vs. 10.3 +/- 0.9 and 11.3 +/- 0.6 mmol/l, p = 0.0003 and p < 0.0001, respectively, with placebo). Thereafter, starting 1 h after breakfast, no significant differences in plasma glucose, insulin, C-peptide or glucagon profiles were found between experiments with GLP-1 (7-36 amide) and placebo. Average plasma glucose concentrations over the whole 24 h period were reduced by 18% by GLP-1 administered overnight. In conclusion, (1) overnight GLP-1 (7-36 amide) normalizes fasting plasma glucose, but (2) has no sustained effect on meal-induced glucose, insulin or glucagon concentrations once its administration has been stopped. (3) Normalization of fasting plasma glucose alone does not improve daytime metabolic control in NIDDM patients on oral agents.
胰高血糖素样肽-1（7-36酰胺）可使非胰岛素依赖型糖尿病（NIDDM）患者的空腹血糖恢复正常。本研究旨在探讨夜间静脉输注胰高血糖素样肽-1（7-36酰胺）对随后24小时血糖谱的影响。选取10例NIDDM患者（7例女性，3例男性；年龄62±4岁，体重指数（BMI）29.6±3.9kg/m²，病程10±7年，糖化血红蛋白（HbA1c）10.9±1.3%（正常4.0-6.1%），接受格列本脲和/或二甲双胍治疗），随机分两次进行研究：分别于22:00至7:00（9小时）静脉输注胰高血糖素样肽-1（7-36酰胺）（德国汉诺威萨克森生化公司产品，1pmol·kg⁻¹·min⁻¹）或安慰剂（含1%人血清白蛋白的0.9%氯化钠溶液，德国马尔堡贝林公司产品），并在输注胰高血糖素样肽-1期间及随后24小时获取血糖谱。胰高血糖素样肽-1（7-36酰胺）（血浆浓度110±12pmol/L）使血浆C肽浓度升高（p=0.0005），抑制胰高血糖素（p=0.01），并在凌晨3:00和7:00时使血浆葡萄糖降至5.5±0.6和6.3±0.4mmol/L（与安慰剂组相比分别为10.3±0.9和11.3±0.6mmol/L；p分别为0.0003和p<0.0001）。此后，从早餐后1小时开始，胰高血糖素样肽-1（7-36酰胺）组与安慰剂组在血浆葡萄糖、胰岛素、C肽或胰高血糖素谱方面未发现显著差异。夜间给予胰高血糖素样肽-1可使整个24小时期间的平均血浆葡萄糖浓度降低18%。总之：（1）夜间输注胰高血糖素样肽-1（7-36酰胺）可使空腹血糖恢复正常，但（2）一旦停止输注，对进食诱导的葡萄糖、胰岛素或胰高血糖素浓度无持续影响；（3）仅使空腹血糖恢复正常并不能改善口服降糖药治疗NIDDM患者的日间代谢控制。
