Involvement of glucagon-like peptide-1 in the glucose-lowering effect of metformin.

Abstract

Metformin is an oral antihyperglycaemic drug used in the first-line treatment of type 2 diabetes. Metformin's classic and most well-known blood glucose-lowering mechanisms include reduction of hepatic gluconeogenesis and increased peripheral insulin sensitivity. Interestingly, intravenously administered metformin is ineffective and recently, metformin was shown to increase plasma concentrations of the glucose-lowering gut incretin hormone glucagon-like peptide-1 (GLP-1), which may contribute to metformin's glucose-lowering effect in patients with type 2 diabetes. The mechanisms behind metformin-induced increments in GLP-1 levels remain unknown, but it has been hypothesized that metformin stimulates GLP-1 secretion directly and/or indirectly and that metformin prolongs the half-life of GLP-1. Also, it has been suggested that metformin may potentiate the glucose-lowering effects of GLP-1 by increasing target tissue sensitivity to GLP-1. The present article critically reviews the possible mechanisms by which metformin may affect GLP-1 levels and sensitivity and discusses whether such alterations may constitute important and clinically relevant glucose-lowering actions of metformin.

• Authors: Emilie Bahne, Morten Hansen, Andreas Brønden, David P Sonne, Tina Vilsbøll, Filip K Knop
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 18 Issue 10 Pg. 955-61 (10 2016) ISSN: 1463-1326 [Electronic] England
• PMID: 27265206 (Publication Type: Journal Article, Review)
• Copyright: © 2016 John Wiley & Sons Ltd.

Chemical References

• Bile Acids and Salts
• Blood Glucose
• Hypoglycemic Agents
• Incretins
• Glucagon-Like Peptide 1
• Metformin

Topics

• Bile Acids and Salts (metabolism)
• Blood Glucose (drug effects, metabolism)
• Diabetes Mellitus, Type 2 (blood, drug therapy)
• Gastrointestinal Microbiome (drug effects)
• Glucagon-Like Peptide 1 (blood, metabolism, physiology)
• Humans
• Hypoglycemic Agents (pharmacology)
• Incretins (therapeutic use)
• Metformin (pharmacology)