Zhang KX, Kan CX, Wang YQ, Hou NN, Sun XD. Intestinal glucagon-like peptide-1 in hypoglycemic counterregulation for type 1 diabetes management. World J Diabetes 2024; 15(12): 2380-2383 [DOI: 10.4239/wjd.v15.i12.2380]
Corresponding Author of This Article
Xiao-Dong Sun, MD, PhD, Chief Doctor, Department of Endocrinology and Metabolism, The Affiliated Hospital of Shandong Second Medical University, No. 2428 Yuhe Road, Weifang 261031, Shandong Province, China. xiaodong.sun@sdsmu.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Dec 15, 2024; 15(12): 2380-2383 Published online Dec 15, 2024. doi: 10.4239/wjd.v15.i12.2380
Intestinal glucagon-like peptide-1 in hypoglycemic counterregulation for type 1 diabetes management
Ke-Xin Zhang, Cheng-Xia Kan, Yu-Qun Wang, Ning-Ning Hou, Xiao-Dong Sun
Ke-Xin Zhang, Cheng-Xia Kan, Yu-Qun Wang, Ning-Ning Hou, Xiao-Dong Sun, Department of Endocrinology and Metabolism, The Affiliated Hospital of Shandong Second Medical University, Weifang 261031, Shandong Province, China
Author contributions: All the authors contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Dong Sun, MD, PhD, Chief Doctor, Department of Endocrinology and Metabolism, The Affiliated Hospital of Shandong Second Medical University, No. 2428 Yuhe Road, Weifang 261031, Shandong Province, China. xiaodong.sun@sdsmu.edu.cn
Received: July 8, 2024 Revised: September 13, 2024 Accepted: October 12, 2024 Published online: December 15, 2024 Processing time: 132 Days and 17.7 Hours
Abstract
Type 1 diabetes (T1D) is characterized by the autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency and the need for exogenous insulin. A significant concern in T1D management is hypoglycemia, which is worsened by impaired counterregulatory mechanisms. Effective counterregulation involves hormones such as glucagon and adrenaline, which work to restore normal blood glucose levels. However, in T1D, these mechanisms often fail, particularly after recurrent hypoglycemia, resulting in hypoglycemia-associated autonomic failure. Recent research indicates that elevated levels of intestinal glucagon-like peptide-1 (GLP-1) impair counterregulatory responses by reducing the secretion of glucagon and adrenaline. This editorial underscores GLP-1’s role beyond its incretin effects, contributing to impaired hypoglycemic counterregulation. This understanding necessitates a nuanced approach to GLP-1-based therapies in T1D, balancing the benefits of glycemic control with potential risks. Future research should delve into the mechanisms behind GLP-1’s effects and explore potential interventions to improve hypoglycemic counterregulation. The goal is to enhance the safety and quality of life for T1D patients.
Core Tip: Elevated intestinal glucagon-like peptide-1 impairs hypoglycemic counterregulation in type 1 diabetes by reducing glucagon and adrenaline secretion. This highlights the need for a balanced approach to glucagon-like peptide-1-based therapies, considering both glycemic control and the risk of hypoglycemia.
