Glucagon-Like Peptide 1: A Predictor of Type 2 Diabetes?

Abstract EN

Background.

The incretin effect is impaired in patients with type 2 diabetes.

Aim.

To assess the relation between the incretin hormone GLP-1 and the prediabetic subtypes: impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and the combined IFG/IGT to investigate whether a low GLP-1 response may be a predictor of prediabetes in adults.

Method.

298 articles were found using a broad search phrase on the PubMed database and after the assessment of titles and abstracts 19 articles were included.

Results and Discussion.

Studies assessing i-IFG/IFG and i-IGT/IGT found both increased, unaltered, and reduced GLP-1 levels.

Studies assessing IFG/IGT found unaltered or reduced GLP-1 levels.

When assessing the five studies with the largest sample size, it clearly suggests a decreased GLP-1 response in IFG/IGT subjects.

Several other factors (BMI, glucagon, age, and nonesterified fatty acids (NEFA)), including medications (metformin), may also influence the secretion of GLP-1.

Conclusion.

This review suggests that the GLP-1 response is a variable in prediabetes possibly due to a varying GLP-1-secreting profile during the development and progression of type 2 diabetes or difference in the measurement technique.

Longitudinal prospective studies are needed to assess whether a reduced GLP-1 response is a predictor of diabetes.