The Effect of Exogenous Glucose-Dependent Insulinotropic Polypeptide in Combination With Glucagon-Like Peptide-1 on Glycemia in the Critically Ill
AuthorLee, MY; Fraser, JD; Chapman, MJ; Sundararajan, K; Umapathysivam, MM; Summers, MJ; Zaknic, AV; Rayner, CK; Meier, JJ; Horowitz, M; ...
Source TitleDiabetes Care
PublisherAMER DIABETES ASSOC
University of Melbourne Author/sDeane, Adam
Document TypeJournal Article
CitationsLee, M. Y., Fraser, J. D., Chapman, M. J., Sundararajan, K., Umapathysivam, M. M., Summers, M. J., Zaknic, A. V., Rayner, C. K., Meier, J. J., Horowitz, M. & Deane, A. M. (2013). The Effect of Exogenous Glucose-Dependent Insulinotropic Polypeptide in Combination With Glucagon-Like Peptide-1 on Glycemia in the Critically Ill. DIABETES CARE, 36 (10), pp.3333-3336. https://doi.org/10.2337/dc13-0307.
Access StatusOpen Access
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.
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