GLP-1 response to oral glucose is reduced in prediabetes, screen-detected type 2 diabetes, and obesity and influenced by sex: the ADDITION-PRO study

K Færch, SS Torekov, D Vistisen, NB Johansen… - Diabetes, 2015 - Am Diabetes Assoc
Diabetes, 2015Am Diabetes Assoc
The role of glucose-stimulated release of GLP-1 in the development of obesity and type 2
diabetes is unclear. We assessed GLP-1 response to oral glucose in a large study
population of lean and obese men and women with normal and impaired glucose
regulation. Circulating concentrations of glucose, insulin, and GLP-1 during an oral glucose
tolerance test (OGTT) were analyzed in individuals with normal glucose tolerance (NGT)(n=
774), prediabetes (n= 525), or screen-detected type 2 diabetes (n= 163) who attended the …
The role of glucose-stimulated release of GLP-1 in the development of obesity and type 2 diabetes is unclear. We assessed GLP-1 response to oral glucose in a large study population of lean and obese men and women with normal and impaired glucose regulation. Circulating concentrations of glucose, insulin, and GLP-1 during an oral glucose tolerance test (OGTT) were analyzed in individuals with normal glucose tolerance (NGT) (n = 774), prediabetes (n = 525), or screen-detected type 2 diabetes (n = 163) who attended the Danish ADDITION-PRO study (n = 1,462). Compared with individuals with NGT, women with prediabetes or type 2 diabetes had 25% lower GLP-1 response to an OGTT, and both men and women with prediabetes or type 2 diabetes had 16–21% lower 120-min GLP-1 concentrations independent of age and obesity. Obese and overweight individuals had up to 20% reduced GLP-1 response to oral glucose compared with normal weight individuals independent of glucose tolerance status. Higher GLP-1 responses were associated with better insulin sensitivity and β-cell function, older age, and lesser degree of obesity. Our findings indicate that a reduction in GLP-1 response to oral glucose occurs prior to the development of type 2 diabetes and obesity, which can have consequences for early prevention strategies for diabetes.
Am Diabetes Assoc