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Type: Journal article
Title: The effect of exogenous glucose-dependent insulinotropic polypeptide in combination with glucagon-like peptide-1 on glycemia in the critically ill
Author: Lee, M.
Fraser, J.
Chapman, M.
Sundararajan, K.
Umapathysivam, M.
Summers, M.
Zaknic, A.
Rayner, C.
Meier, J.
Horowitz, M.
Deane, A.
Citation: Diabetes Care, 2013; 36(10):3333-3336
Publisher: Amer Diabetes Assoc
Issue Date: 2013
ISSN: 0149-5992
Statement of
Michael Y. Lee, Jonathan D. Fraser, Marianne J. Chapman, Krishnaswamy Sundararajan, Mahesh M. Umapathysivam, Matthew J. Summers, Antony V. Zaknic, Christopher K. Rayner, Juris J. Meier, Michael Horowitz, Adam M. Deane
Abstract: OBJECTIVE Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) have additive insulinotropic effects when coadministered in health. We aimed to determine whether GIP confers additional glucose lowering to that of GLP-1 in the critically ill. RESEARCH DESIGN AND METHODS Twenty mechanically ventilated critically ill patients without known diabetes were studied in a prospective, randomized, double-blind, crossover fashion on 2 consecutive days. Between T₀ and T₄₂₀ minutes, GLP-1 (1.2 pmol/kg • min−1) was infused intravenously with either GIP (2 pmol/kg • min⁻¹) or 0.9% saline. Between T₆₀ and T₄₂₀ minutes, nutrient liquid was infused into the small intestine at 1.5 kcal/min. RESULTS Adding GIP did not alter blood glucose or insulin responses to small intestinal nutrient. GIP increased glucagon concentrations slightly before nutrient delivery (P = 0.03), but not thereafter. CONCLUSIONS The addition of GIP to GLP-1 does not result in additional glucose-lowering or insulinotropic effects in critically ill patients with acute-onset hyperglycemia.
Keywords: Humans
Critical Illness
Gastric Inhibitory Polypeptide
Blood Glucose
Prospective Studies
Cross-Over Studies
Double-Blind Method
Middle Aged
Glucagon-Like Peptide 1
Rights: © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.
DOI: 10.2337/dc13-0307
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