Recently published studies of islet cell function reveal unexpected features of glucagon-like peptide-1 (GLP-1) receptor-mediated signal transduction in the pancreatic -cell. Although GLP-1 is established to be a cAMPelevating agent, these studies demonstrate that protein kinase A (PKA) is not the only cAMP-binding protein by which GLP-1 acts. Instead, an alternative cAMP signaling mechanism has been described, one in which GLP-1 activates cAMP-binding proteins designated as cAMPregulated guanine nucleotide exchange factors (cAMPGEFs, also known as Epac). T he insulin secretagogue hormone glucagon-like peptide-1 (GLP-1) and its structurally related peptide analogs NN2211, CJC-1131, and exendin-4 are potent stimulators of the pancreatic -cell GLP-1 receptor (GLP-1-R) (1-4). When administered to type 2 diabetic subjects, these peptides exert multiple antidiabetogenic effects: they stimulate insulin secretion, they lower fasting concentrations of blood glucose, and they attenuate the elevation of blood glucose concentration that is typically observed following ingestion of a meal. Such beneficial blood glucose-lowering actions of GLP-1 indicate a usefulness of the hormone as a new therapeutic agent for the treatment of diabetes. Indeed, efforts are now under way to develop synthetic analogs of GLP-1 that exhibit an optimal pharmacokinetic and pharmacodynamic spectrum of action commensurate with their use as therapeutic agents (1).Simultaneously, efforts have been directed at elucidating the molecular basis for GLP-1-R-mediated signal transduction. Previous studies demonstrate that GLP-1 activates multiple signaling pathways in the -cell (Fig. 1). These pathways include protein kinase A (PKA), Ca 2ϩ / calmodulin-regulated protein kinase (CaMK), mitogenactivated protein kinases (MAPK, ERK1/2), phosphatidylinositol 3-kinase (PI-3K), protein kinase B (PKB, Akt), and atypical protein kinase C-(PKC-). In addition, evidence exists for actions of GLP-1 mediated by protein phosphatase (calcineurin) and hormone-sensitive lipase. Some of these signaling pathways are likely to play an active role in determining the effectiveness of GLP-1 as a stimulus for pancreatic insulin secretion. They may also confer trophic factor-like actions to GLP-1 that underlie its ability to stimulate -cell growth, differentiation, and survival (1).Recent studies of pancreatic -cell stimulus-secretion coupling reveal the existence of an alternative cAMP signal transduction pathway by which GLP-1 may exert its effects (5-12). GLP-1 is shown to stimulate cAMP production, and the action of cAMP is demonstrated to be mediated not only by PKA, but also by a newly recognized family of cAMP-binding proteins designated as cAMP-regulated guanine nucleotide exchange factors (cAMPGEFs, also known as Epac) (13,14). Identification of Epac as an intermediary linking the GLP-1-R to the stimulation of insulin secretion has led to an appreciation that the blood glucose-lowering effect of GLP-1 might be reproduced using pharmacological agents that activate cAMP...