Mayo Clinic
The investigators recently demonstrated that blockade of Glucagon-Like Peptide-1's (GLP-1) receptor (GLP1R) results in changes in islet function without changes in circulating GLP-1. These effects are more pronounced in people with early type 2 diabetes (T2DM) in keeping with increased expression of PC-1/3 and GLP-1 that is observed in diabetic islets. However, its regulation is at present unknown. There is evidence that α-cell proglucagon processing is subject to paracrine regulation by the β-cell3. It is unclear if the effects of GLP1R agonism on islet GLP-1 differ in Type 1 diabetes (T1DM) compared to T2DM. This experiment will examine the effect of glycemic control ± a GLP1R agonist on islet GLP-1 in people with (T2DM) and without (T1DM) β-cells.
The investigators recently demonstrated that blockade of Glucagon-Like Peptide-1's (GLP-1) receptor (GLP1R) results in changes in islet function without changes in circulating GLP-1. This supports other evidence (rodents and humans) that through the (inducible) expression of a prohormone convertase (PC-1/3), the α-cell can process proglucagon to intact GLP-15,6. 'Islet' or 'pancreatic' GLP-1 acts in a paracrine fashion to regulate insulin (basal and 1st phase) and glucagon secretion. These effects are more pronounced in people with early type 2 diabetes (T2DM) in keeping with increased express…
Inclusion Criteria: * Type 1 or type 2 diabetes treated with insulin Exclusion Criteria: 1. Age \< 25 or \> 70 years. 2. HbA1c \> 10.0% 3. For female subjects: positive pregnancy test at the time of enrollment or study 4. History of prior upper abdominal surgery such as adjustable gastric banding, pyloroplasty and vagotomy. 5. Prior use of GLP-1 receptor agonists in the previous year. 6. Active systemic illness or malignancy. 7. Symptomatic macrovascular or microvascular disease.
Liraglutide 0.6mg
Saline in syringes to serve as placebo for single blind study
Arctuva estimate
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