Diabetologie und Stoffwechsel 2023; 18(S 01): S7
DOI: 10.1055/s-0043-1767844
Abstracts | DK 2023
Freie Vorträge
Freie-Vorträge-Symposium II

The Role of Hyperglucagonemia in Diabetes Remission

Authors

  • Elena Lalama

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Jiudan Zhang

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Kilian Ruetther

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Bettina Schuppelius

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Marta Csanalosi

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Stefan Kabisch

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany

  • Nicolle Kränkel

    2   Charité - Universitätsmedizin Berlin, CBF, Medizinische Klinik für Kardiologie, Berlin, Germany

  • Eicke Latz

    3   University of Bonn, Institut für Angeborene Immunität, Bonn, Germany

  • Anette Christ

    3   University of Bonn, Institut für Angeborene Immunität, Bonn, Germany

  • Domenico Trico

    4   University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy

  • Andrea Mari

    5   CNR - Consiglio Nazionale delle Ricerche, CNR - Institute of Neuroscience, Padova, Italy

  • Andreas Pfeiffer

    1   Charité - Universitätsmedizin Berlin, CBF, Department of Endocrinology and Metabolic Diseases, Berlin, Germany
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Background Glucagon (GCG) plays an important role in the early development of diabetes by causing a feed-forward cycle of hyperinsulinemia and insulin resistance. The opposite view emphasizes that intra-islet alpha-beta-cell crosstalk is essential for intact insulin secretion and GCG determines hepatic fat oxidation, thus supporting intact metabolism. We investigated the role of GCG in diabetes remission within our “FAIR” study - Fasting-Associated Immune-metabolic Remission of Diabetes.

Methods We studied 31 Participants with T2D and overweight before and after a 3-month very-low-calorie diet. Mixed-Meal Tests (MMT) were done before and after intervention, GCG, insulin, C-peptide, glucose and clinical routine and anthropometric values were collected. We compared tertiles of low, middle and high fasting GCG levels at baseline regarding insulin, glucose, HbA1c and calculated insulin sensitivity and secretion.

Results The weight loss was 17±3.8 kg. Fasting and MMT-AUC glucose, HbA1c, HOMA and Matsuda index improved significantly, and insulin decreased throughout the cohort indicating improved insulin sensitivity. Baseline and postprandial hyperglucagonemia decreased significantly in the middle and highest tertiles of glucagon only. By contrast, beta-cell glucose sensitivity improved significantly in the lower but not in the middle and highest glucagon tertiles.[1] [2] [3]

Conclusion Diabetes remission is related to remission of hyperglucagonemia in participants with high baseline and postprandial plasma glucagon which drives hyperglycemia. By contrast, improved beta-cell function shown as improved beta-cell glucose sensitivity determines remission in the absence of hyperglucagonemia. Beta-cell responses therefore vary extensively depending on the presence of absence of hyperglucagonemia.



Publikationsverlauf

Artikel online veröffentlicht:
02. Mai 2023

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