Authors of a pilot study in this weeks issue of THE LANCET suggest that a naturally occurring intestinal hormone could be beneficial for the future treatment of type 2 diabetes.

Type 2 diabetes affects an estimated 10% of adults over 60 years of age, and has recently been reported in teenage children. Treatment for the disorder usually includes alteration to diet, exercise, oral hypoglycaemic agents (which lower blood glucose), and insulin. The naturally occurring hormone glucagon-like peptide 1 (GLP-1) has been proposed as a treatment for type 2 diabetes; this hormone is associated with insulin production, and is present in lower concentrations in people with type 2 diabetes. Jens Juul Holst and colleagues from the University of Copenhagen, Denmark, investigated the effects of continuous administration of GLP-1 in a 6-week pilot study.

20 patients with type 2 diabetes were given either subcutaneous GLP-1 or saline (used as a control) continuously for six weeks. Assessments including b-cell function, measurement of blood glucose concentration, insulin sensitivity, and ratings of appetite were recorded at 0, 1, and 6 weeks.

In the GLP-1 group, fasting and eight-hour average blood glucose decreased by 4.3 mmol/L and 5.5 mmol/L respectively. Bodyweight decreased by 1.9 kg, and appetite was reduced. Both insulin sensitivity and b-cell function improved, and there were no reported side-effects.

Jens Juul Holst comments: The study shows that a GLP-1 based treatment is likely to be effective in the long-term. Some sort of failure might have been expected, because treatment is based on an exaggerated supply of one of the natural factors of blood-glucose regulation. The improved insulin sensitivity, b-cell function, body weight and free-fatty-acid levels during treatment cou
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Lancet
7-Mar-2002