Circulating levels of gastrointestinal hormones in prediabetes reversing to normoglycemia or progressing to diabetes in a year-A cross-sectional and prospective analysis

Diabetes Res Clin Pract. 2023 May:199:110636. doi: 10.1016/j.diabres.2023.110636. Epub 2023 Mar 20.

Abstract

Aims: We aimed to compare the concentrations of GLP-1, glucagon and GIP (established regulators of glucose homeostasis) and glicentin (emerging new metabolic marker)during an OGTT in patients with normal glucose tolerance (NGT), prediabetes and diabetes at onset, and one-year before, when all had prediabetes.

Methods: GLP-1, glucagon, GIP and glicentin concentrations were measured and compared with markers of body composition, insulin sensitivity and β-cell function at a 5-timepoint OGTT in 125 subjects (30 diabetes, 65 prediabetes, 30 NGT) and in 106 of them one-year before, when all had prediabetes.

Results: At baseline, when all subjects were in prediabetic state, hormonal levels did not differ between groups. One year later, patients progressing to diabetes had lower postprandial increases of glicentin and GLP-1, lower postprandial decrease of glucagon, and higher levels of fasting GIP compared to patients regressing to NGT. Changes in glicentin and GLP-1 AUC within this year correlated negatively with changes in Glucose AUC of OGTT and with changes in markers of beta cell function.

Conclusion: Incretins, glucagon and glicentin profiles in prediabetic state cannot predict future glycemic traits, but prediabetes progressing to diabetes is accompanied by deterioration of postprandial increases of GLP-1 and glicentin.

Keywords: Incretins; Proglucagon-Derived Peptides; Type 2 Diabetes Mellitus.

MeSH terms

  • Blood Glucose / metabolism
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2*
  • Gastric Inhibitory Polypeptide
  • Gastrointestinal Hormones*
  • Glicentin
  • Glucagon
  • Glucagon-Like Peptide 1
  • Glucose Tolerance Test
  • Humans
  • Insulin / metabolism
  • Prediabetic State*

Substances

  • Gastrointestinal Hormones
  • Glucagon
  • Insulin
  • Glicentin
  • Blood Glucose
  • Glucagon-Like Peptide 1
  • Gastric Inhibitory Polypeptide