GIP Infusion reduces Postprandial blood sugar fluctuations in Type 1 Diabetes: Study
A large number of epidemiological and pathophysiological studies have demonstrated that postprandial (PP) hyperglycemia contributes greatly to overall blood sugar control assessed by HbA1c, and increases the risk of micro- and macrovascular complications in diabetic patients. In patients with T1DM, achieving an optimal PP blood sugar control remains challenging, even if the growing use of continuous glucose monitoring (CGM) systems provides a detailed picture of daily blood sugar fluctuations, including those occurring in postprandial periods.
According to a recently published study in Cardiology ,GIP infusion seemed to attenuate postprandial plasma glucose excursions without significantly increasing the need of glucose to avoid episodes of extremely low blood sugar in patients with T1D.
During the past 30 years, the involvement of several gut-derived peptides in the regulation of pancreatic islet secretion has been progressively uncovered. One such gut-derived factor is glucose-dependent insulinotropic polypeptide (GIP), a polypeptide hormone secreted from the small-intestinal K cells in response to nutrient intake . GIP is well founded as an incretin hormone potentiating insulin release from β-cells in healthy humans . In addition to insulinotropic effects, early studies also delineated the glucagon-releasing properties of GIP by demonstrating that GIP stimulates glucagon secretion from α-cells in the perfused rat pancreas at glucose concentrations <5.5 mmol/L.
To date, Gluco-regulatory effects of the insulinotropic and glucagonotropic gut hormone glucose-dependent insulinotropic polypeptide (GIP) in type 1 diabetes (T1D) are unclear.
Researchers under BJØRN HOE ,from Hellerup, Denmark evaluated the effects of exogenous and endogenous GIP on plasma glucose excursions in a setting of prandial insulin over-dose and physical activity after meal ingestion.
The study design consisted of a randomized, placebo-controlled, double-blinded, crossover study, 12 men with T1D (age [mean±SD]: 26±6.6 years; BMI: 23±2.3 kg/m2; HbA1c: 6.5±2.7% (48.4±6.3 mmol/mol); diabetes duration: 11.3±5.5 years; plasma C-peptide <200 pmol/L) underwent three separate study days involving a liquid mixed meal test with 125% of regular prandial insulin dose, 30 minutes of intermediate bicycling (60 minutes after mixed-meal), and 270 minute infusions of GIP, the GIP receptor antagonist GIP(3-30)NH2 and placebo, respectively.
On data analysis, the following facts emrged.
- The GIP infusion attenuated postprandial plasma glucose excursions (Cmax-Cmin) by [mean±SEM] 1.5±0.5 mmol/L and 0.92±0.56 mmol/L compared to GIP(3-30)NH2 and placebo, respectively (P=0.03).
- Infused glucose needed to avoid plasma glucose <2.5 mmol/L was similar on all 3 study days (P=0.13).For full article click on the link :https://doi.org/10.2337/db20-89-LB
Primary source: Cardiology
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