Direct effects of exendin-(9, 39) and GLP-1-(9, 36) amide on insulin action, β-cell function, and glucose metabolism in nondiabetic subjects

M Sathananthan, LP Farrugia, JM Miles, F Piccinini… - Diabetes, 2013 - Am Diabetes Assoc
M Sathananthan, LP Farrugia, JM Miles, F Piccinini, C Dalla Man, AR Zinsmeister, C Cobelli
Diabetes, 2013Am Diabetes Assoc
Exendin-(9, 39) is a competitive antagonist of glucagon-like peptide-1 (GLP-1) at its
receptor. However, it is unclear if it has direct and unique effects of its own. We tested the
hypothesis that exendin-(9, 39) and GLP-1-(9, 36) amide have direct effects on hormone
secretion and β-cell function as well as glucose metabolism in healthy subjects. Glucose
containing [3-3H] glucose was infused to mimic the systemic appearance of glucose after a
meal. Saline, GLP-1-(9, 36) amide, or exendin-(9, 39) at 30 pmol/kg/min (Ex 30) or 300 …
Exendin-(9,39) is a competitive antagonist of glucagon-like peptide-1 (GLP-1) at its receptor. However, it is unclear if it has direct and unique effects of its own. We tested the hypothesis that exendin-(9,39) and GLP-1-(9,36)amide have direct effects on hormone secretion and β-cell function as well as glucose metabolism in healthy subjects. Glucose containing [3-3H]glucose was infused to mimic the systemic appearance of glucose after a meal. Saline, GLP-1-(9,36)amide, or exendin-(9,39) at 30 pmol/kg/min (Ex 30) or 300 pmol/kg/min (Ex 300) were infused in random order on separate days. Integrated glucose concentrations were slightly but significantly increased by exendin-(9,39) (365 ± 43 vs. 383 ± 35 vs. 492 ± 49 vs. 337 ± 50 mmol per 6 h, saline, Ex 30, Ex 300, and GLP-1-[9,36]amide, respectively; P = 0.05). Insulin secretion did not differ among groups. However, insulin action was lowered by exendin-(9,39) (25 ± 4 vs. 20 ± 4 vs. 18 ± 3 vs. 21 ± 4 10−4 dL/kg[min per μU/mL]; P = 0.02), resulting in a lower disposition index (DI) during exendin-(9,39) infusion (1,118 ± 118 vs. 816 ± 83 vs. 725 ± 127 vs. 955 ± 166 10−14 dL/kg/min2 per pmol/L; P = 0.003). Endogenous glucose production and glucose disappearance did not differ significantly among groups. We conclude that exendin-(9,39), but not GLP-1-(9,36)amide, decreases insulin action and DI in healthy humans.
Am Diabetes Assoc