Preserved GLP-1 effects in a diabetic patient with Cushing's disease
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Preserved GLP-1 effects in a diabetic patient with Cushing's disease. / Ritzel, R A; Kleine, N; Holst, Jens Juul; Willms, B; Schmiegel, W; Nauck, M A.
I: Experimental and Clinical Endocrinology and Diabetes, Bind 115, Nr. 2, 02.2007, s. 146-50.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Preserved GLP-1 effects in a diabetic patient with Cushing's disease
AU - Ritzel, R A
AU - Kleine, N
AU - Holst, Jens Juul
AU - Willms, B
AU - Schmiegel, W
AU - Nauck, M A
PY - 2007/2
Y1 - 2007/2
N2 - CONTEXT: A patient with diabetes mellitus, who participated in a study with intravenous administration of GLP-1, was later found to have Cushing's disease (markedly elevated 24 h urinary cortisol excretion and inadequate suppression of fasting cortisol with 2 mg dexamethasone). His diabetic state disappeared (2 h plasma glucose after 75 g oral glucose 159 mg/dl=IGT) after successful pituitary surgery (normal 24 h urinary cortisol excretion and adequate cortisol suppression with 2 mg dexamethasone).OBJECTIVE: The present analysis was undertaken to compare GLP-1 actions on fasting glycemia in diabetes mellitus due to Cushing's disease with GLP-1 actions in typical type 2 diabetes.DESIGN AND METHODS: GLP-1 (1.2 pmol/kg/min) and placebo had been infused into ten patients with diabetes mellitus over 4 h in the fasting state. The results from the patient with Cushing's disease (C) were compared to the data from the remaining nine patients with type 2 diabetes (D).RESULTS: Within 4 h glucose decreased from basal (C: 12.9; D: 12.9+/-0.7 mmol/l) to normal fasting values (C: 5.0; D: 4.9+/-0.4 mmol/l). The stimulation of insulin secretion and suppression of glucagon secretion was similar in the patient with Cushing's disease compared to those with type 2 diabetes.CONCLUSIONS: The insulinotropic, glucagonostatic and glucose-lowering actions of GLP-1 in a patient with diabetes mellitus due to cortisol excess were similar to actions in typical type 2 diabetes. Therefore incretin mimetics might be a novel therapeutic strategy for the treatment of glucocorticoid-induced diabetes mellitus.
AB - CONTEXT: A patient with diabetes mellitus, who participated in a study with intravenous administration of GLP-1, was later found to have Cushing's disease (markedly elevated 24 h urinary cortisol excretion and inadequate suppression of fasting cortisol with 2 mg dexamethasone). His diabetic state disappeared (2 h plasma glucose after 75 g oral glucose 159 mg/dl=IGT) after successful pituitary surgery (normal 24 h urinary cortisol excretion and adequate cortisol suppression with 2 mg dexamethasone).OBJECTIVE: The present analysis was undertaken to compare GLP-1 actions on fasting glycemia in diabetes mellitus due to Cushing's disease with GLP-1 actions in typical type 2 diabetes.DESIGN AND METHODS: GLP-1 (1.2 pmol/kg/min) and placebo had been infused into ten patients with diabetes mellitus over 4 h in the fasting state. The results from the patient with Cushing's disease (C) were compared to the data from the remaining nine patients with type 2 diabetes (D).RESULTS: Within 4 h glucose decreased from basal (C: 12.9; D: 12.9+/-0.7 mmol/l) to normal fasting values (C: 5.0; D: 4.9+/-0.4 mmol/l). The stimulation of insulin secretion and suppression of glucagon secretion was similar in the patient with Cushing's disease compared to those with type 2 diabetes.CONCLUSIONS: The insulinotropic, glucagonostatic and glucose-lowering actions of GLP-1 in a patient with diabetes mellitus due to cortisol excess were similar to actions in typical type 2 diabetes. Therefore incretin mimetics might be a novel therapeutic strategy for the treatment of glucocorticoid-induced diabetes mellitus.
KW - Blood Glucose
KW - Diabetes Mellitus, Type 2
KW - Female
KW - Glucagon-Like Peptide 1
KW - Humans
KW - Hydrocortisone
KW - Insulin
KW - Male
KW - Middle Aged
KW - Pituitary ACTH Hypersecretion
U2 - 10.1055/s-2007-955096
DO - 10.1055/s-2007-955096
M3 - Journal article
C2 - 17318778
VL - 115
SP - 146
EP - 150
JO - Experimental and Clinical Endocrinology and Diabetes
JF - Experimental and Clinical Endocrinology and Diabetes
SN - 0947-7349
IS - 2
ER -
ID: 132050370