Glucagon is the key factor in the development of diabetes

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• 作者：Young H. Lee ; May-Yun Wang ; Xin-Xin Yu ; Roger H. Unger
• 刊名：Diabetologia
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：59
• 期：7
• 页码：1372-1375
• 全文大小：240 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Internal Medicine
  Metabolic Diseases
  Human Physiology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0428
• 卷排序：59

文摘

Glucagon plays important roles in normal glucose homeostasis and in metabolic abnormalities, particularly diabetes. Glucagon excess, rather than insulin deficiency, is essential for the development of diabetes for several reasons. Glucagon increases hepatic glucose and ketone production, the catabolic features of insulin deficiency. Hyperglucagonaemia is present in every form of diabetes. Beta cell destruction in glucagon receptor null mice does not cause diabetes unless mice are administered adenovirus encoding the glucagon receptor. In rodent studies the glucagon suppressors leptin and glucagon receptor antibody suppressed all catabolic manifestations of diabetes during insulin deficiency. Insulin prevents hyperglycaemia; however, insulin monotherapy cannot cure diabetes such that non-diabetic glucose homeostasis is achieved. Glucose-responsive beta cells normally regulate alpha cells, and diminished insulin action on alpha cells will favour hypersecretion of glucagon by the alpha cells, thus altering the insulin:glucagon ratio. Treating diabetes by suppression of glucagon, with leptin or antibody against the glucagon receptor, normalised glucose level (without glycaemic volatility) and HbA_1c. Glucagon suppression also improved insulin sensitivity and glucose tolerance. If these results can be translated to humans, suppression of glucagon action will represent a step forward in the treatment of diabetes. This review summarises a presentation given at the ‘Novel data on glucagon’ symposium at the 2015 annual meeting of the EASD. It is accompanied by two other reviews on topics from this symposium (by Mona Abraham and Tony Lam, DOI: 10.1007/s00125-016-3950-3, and by Russell Miller and Morris Birnbaum, DOI: 10.1007/s00125-016-3955-y) and an overview by the Session Chair, Isabel Valverde (DOI: 10.1007/s00125-016-3946-z).KeywordsGcgr−/− miceGCGR-AbGlucagonGlucagon suppressionHbA_1cInsulinInsulin:glucagon ratioReview