The Role of Glucagon in Glycemic Variability in Type 1 Diabetes: A Narrative Review

Guo, Keyu; Tian, Qiang; Yang, Lin; Zhang, Zhou

doi:10.2147/dmso.s343514

Cited by 9 publications

(6 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…T1DM is characterized by pancreatic α-cell dysfunction in addition to β-cell dysfunction [ 5 ]. Accordingly, there is impairment in glucagon secretion and release in addition to the better known defects in insulin secretion and release.…”

Section: Discussionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

2022

View full text Add to dashboard Cite

The efficacy of GLP-1 receptor agonists in type 2 diabetes is well established, but their role in type 1 diabetes (T1DM) is less clear. A 36-year-old female with a 27 year history of T1DM and undetectable c-peptide presented for review of weight management, with body mass index 29.3 kg/m2. A previous trial of dapagliflozin led to no improvement in weight or glycemic control. Semaglutide was introduced (0.25 mg weekly increased to 0.5 mg weekly) and was well tolerated. After 6-months, weight had decreased by 16 kg and insulin dose by 36%. Despite less insulin, HbA1c improved, with reduced glycemic variability and no increase in hypoglycemia. Semaglutide may exert significant metabolic benefits in patients with established T1DM, even where c-peptide is no longer detectable. This case supports the need for a dedicated trial examining potential benefits of semaglutide in T1DM.

show abstract

Section: Discussionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

2022

View full text Add to dashboard Cite

show abstract

“…Besides insulin, glucagon is another important hormone that regulates glucose homeostasis. Studies have proved that patients with aberrant glucagon secretion are more prone to have insulin‐induced hypoglycaemia and postprandial hyperglycaemia, leading to higher glycaemic fluctuations 7,27 . The functional integrity of glucagon secretion depends on the preserved regulation of insulin secretion, 28 while the decline of beta‐cell function might induce alpha cell dysfunction 29,30 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies have proved that patients with aberrant glucagon secretion are more prone to have insulin-induced hypoglycaemia and postprandial hyperglycaemia, leading to higher glycaemic fluctuations. 7,27 The functional integrity of glucagon secretion depends on the preserved regulation of insulin secretion, 28 while the decline of beta-cell function might induce alpha cell dysfunction. 29,30 Although our study did not measure glucagon secretion function in the participants, it is reasonable to assume that patients with a low level of ISSI2 might have a worse alpha cell function, which also contributed to the decreased number achieving the targets.…”

Section: Discussionmentioning

confidence: 99%

Association between residual islet beta‐cell function and achieving the target of time in range in inpatients with type 2 diabetes undergoing antidiabetic treatment: An observation study

Xia

You

et al. 2023

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Aim: To assess whether the beta-cell function of inpatients undergoing antidiabetic treatment influences achieving time in range (TIR) and time above range (TAR) targets. Materials and Methods:This cross-sectional study included 180 inpatients with type 2 diabetes. TIR and TAR were assessed by a continuous glucose monitoring system, with target achievement defined as TIR more than 70% and TAR less than 25%. Beta-cell function was assessed by the insulin secretion-sensitivity index-2 (ISSI2).Results: Following antidiabetic treatment, logistic regression analysis showed that lower ISSI2 was associated with a decreased number of inpatients achieving TIR

show abstract

“…Type 1 diabetes mellitus (T1DM) is a progressive disease as a result of the severe destruction of islet β-cell function, and exogenous insulin is not only essential for more efficiently control of blood glucose levels, but also for T1DM patients to stay in life. ( 1 ). In the 100 years since the discovery of insulin, a great progress has been made in our ability to manage T1DM effectively, largely because of the improvements in insulin formulation and delivery ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis

Guo

Zhang

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

ObjectiveRegarding the effects and practical application of insulin pumps on patients with type 1 diabetes mellitus (T1DM), the real-world evidence is limited especially concerning the incidence of hypoglycemia. This study aimed to compare the efficacy of continuous subcutaneous insulin infusion (CSII) therapy with multiple daily injection (MDI) therapy on glycemic metrics evaluated by retrospective continuous glucose monitoring (CGM) in Chinese patients with T1DM.MethodsIn total, 362 T1DM Chinese patients from the outpatient department of the Second Xiangya Hospital, Central South University, who underwent intensive insulin therapy and used a retrospective CGM system were included in this retrospective cross-sectional study. Comprehensive analysis of clinical and biological features and retrospective CGM derived-metrics was performed on the 362 enrolled T1DM patients who underwent CSII (n = 61) or MDI (n = 301) therapy (defined as 4 or more insulin injections per day).ResultsOur findings demonstrated that patients who underwent CSII therapy, compared with those who received MDI therapy, had lower levels of hemoglobin A1c (HbA1c) and fasting blood glucose; moreover, CSII therapy was associated with better glycemic outcomes in terms of increasing time in range (TIR), decreasing time above range (TAR), and achieving CGM-associated targets of TIR ≥70% and TAR <25%. However, patients who underwent CSII therapy did not experience decreasing time below range (TBR), achieving CGM-associated targets of TBR <4%, and reduction of the risk of hypoglycemia as evidenced by comparing TBR and low blood glucose index (LBGI) between the two treatment regimens. The parameters of glycemic variability, such as standard deviation of glucose (SD), mean amplitude glycemic excursion (MAGE), and large amplitude glycemic excursion (LAGE) in T1DM patients who underwent CSII therapy outperformed.ConclusionOur results provided further evidence that CSII therapy is safe and effective for management of Chinese T1DM patients, which was confirmed by a lower HbA1c level and better CGM-derived metrics but no demonstration of improvment in the risk of hypoglycemia. To achieve more satisfactory glycemic outcomes through the utilization of CSII therapy for Chinese T1DM patients, a strong physician-patient relationship is essential.

show abstract

The Role of Glucagon in Glycemic Variability in Type 1 Diabetes: A Narrative Review

Cited by 9 publications

References 108 publications

Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

Association between residual islet beta‐cell function and achieving the target of time in range in inpatients with type 2 diabetes undergoing antidiabetic treatment: An observation study

Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis

Contact Info

Product

Resources

About