Glucagon Sensitivity Similar in Individuals With and Without Type 1 Diabetes: Study Finds

The metabolic effects of glucagon beyond its role in promoting endogenous glucose production in type 1 diabetes are poorly understood. Therefore, Rui She, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, and colleagues aimed to evaluate the metabolic responses to glucagon stimulation in individuals with type 1 diabetes and to determine whether recent hypoglycemia influences glucagon sensitivity.

For this purpose, the researchers enrolled 29 participants, including 19 individuals with type 1 diabetes and 10 healthy controls. They underwent a hyperinsulinemic-euglycemic clamp procedure with five stepwise ascending glucagon injections, during which metabolic responses were evaluated before and after each injection.

The study led to the following findings:

• The incremental area under the curve (AUC) for plasma glucose concentration during glucagon injections was similar between individuals with type 1 diabetes and healthy controls.
• During the first injection of 10 μg glucagon, individuals with type 1 diabetes showed a higher incremental AUC for plasma glucose concentration than healthy controls.
• Plasma concentrations of non-esterified fatty acids, glycerol, and metabolites from metabolomic analyses were comparable between the groups.
• In participants with type 1 diabetes, recent hypoglycemia did not affect the metabolic responses to glucagon.

"These findings provide a clearer understanding of how glucagon functions in type 1 diabetes and offer a foundation for future research into therapeutic approaches. As researchers continue to explore the nuanced role of glucagon, these insights may contribute to improved treatment strategies for individuals with type 1 diabetes, aiming to balance metabolic processes more effectively," the researchers wrote.

"Overall, metabolic responses to glucagon stimulation in individuals with type 1 diabetes are comparable to those in healthy controls. However, participants with type 1 diabetes showed increased glucose production at the lowest glucagon dose, suggesting heightened sensitivity to low-dose glucagon," they concluded.

Reference:

She, R., Suvitaival, T., Andersen, H. U., Hommel, E., Nørgaard, K., & Wojtaszewski, J. F. Metabolic Effects of Glucagon Stimulations in Type 1 Diabetes and Healthy Controls. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgaf030