It is well known that the action of glucose on pancreatic islets results in increased plasma insulin levels. Nevertheless, high blood glucose levels are not solely responsible for increased insulin secretion (for review, see Ref. 1). For example, in 1964 McIntyre et al. (2) demonstrated that intravenous injection of glucose resulted in a smaller insulin release than that resulting from intrajejunal glucose injection, even though the latter produced lower blood glucose levels compared with the former. Hence, glucose-dependent insulin secretion requires a nutrientdependent component, which was believed to be an endocrine transmitter termed an "incretin" (3). It has since been demonstrated that two hormones, glucagon-like peptide-1 and glucosedependent insulinotropic polypeptide, are responsible for the incretin effect (1).The predominant active form of GLP-1 is actually glucagonlike peptide-1(7-36)amide (termed GLP-1 1 throughout this paper), a 30-residue peptide hormone derived from the post-translational modification of proglucagon in intestinal L cells (1). GLP-1 not only increases glucose-dependent insulin secretion (4 -6), but it also decreases glucose-dependent glucagon secretion (7, 8) and decelerates gastric emptying (9). In addition, GLP-1 has been shown to reduce appetite in rats (10) and to stimulate proinsulin gene transcription and biosynthesis in pancreatic -cells (11, 12). The physiological roles of GLP-1 in maintaining blood sugar levels, via a glucose-dependent mechanism, have heightened interest in the GLP-1 receptor (GLP-1R) as a target for glucose-dependent therapeutic agents designed to treat hyperglycemia resulting from diabetes (13,14). Unfortunately, the half-life of GLP-1 itself after subcutaneous injection is very short because of dipeptidyl peptidase IV cleavage of the first 2 N-terminal residues (15), and so future research requires the design of physiologically stable GLP-1R agonists.The venom of the Gila monster Heloderma suspectum contains a mixture of compounds that includes several peptides related in sequence to GLP-1. Two of these, exendin-3 and exendin-4, are 39-amino acid peptides that share ϳ50% sequence identity to GLP-1 itself and are indeed potent GLP-1R agonists (Fig. 1) (16, 17). Interestingly, although GLP-1 affinity is highly sensitive to N-terminal cleavage, exendin-4 can be truncated by up to 8 residues at its N terminus without significant loss of affinity, suggesting that relative to GLP-1, the central and/or C-terminal residues form additional stabilizing contacts with the receptor (15, 18). Nevertheless, the first two amino acids are also essential for the efficacy of exendin peptides because, once removed, the truncated exendin peptides function as antagonists or inverse agonists (16 -19).