Coadministration of Glucagon-Like Peptide-1 During Glucagon Infusion in Humans Results in Increased Energy Expenditure and Amelioration of Hyperglycemia
- Tricia M. Tan1,
- Benjamin C.T. Field1,
- Katherine A. McCullough1,
- Rachel C. Troke1,
- Edward S. Chambers1,
- Victoria Salem1,
- Juan Gonzalez Maffe2,
- Kevin C.R. Baynes1,
- Akila De Silva1,
- Alexander Viardot1,
- Ali Alsafi1,
- Gary S. Frost1,
- Mohammad A. Ghatei1 and
- Stephen R. Bloom1⇑
- 1Section of Investigative Medicine, Imperial College London, London, U.K.
- 2Imperial Clinical Trials Unit, Imperial College London, London, U.K.
- Corresponding author: Stephen R. Bloom, .
T.M.T. and B.C.T.F. contributed equally to this study.
Glucagon and glucagon-like peptide (GLP)-1 are the primary products of proglucagon processing from the pancreas and gut, respectively. Giving dual agonists with glucagon and GLP-1 activity to diabetic, obese mice causes enhanced weight loss and improves glucose tolerance by reduction of food intake and by increase in energy expenditure (EE). We aimed to observe the effect of a combination of glucagon and GLP-1 on resting EE and glycemia in healthy human volunteers. In a randomized, double-blinded crossover study, 10 overweight or obese volunteers without diabetes received placebo infusion, GLP-1 alone, glucagon alone, and GLP-1 plus glucagon simultaneously. Resting EE—measured using indirect calorimetry—was not affected by GLP-1 infusion but rose significantly with glucagon alone and to a similar degree with glucagon and GLP-1 together. Glucagon infusion was accompanied by a rise in plasma glucose levels, but addition of GLP-1 to glucagon rapidly reduced this excursion, due to a synergistic insulinotropic effect. The data indicate that drugs with glucagon and GLP-1 agonist activity may represent a useful treatment for type 2 diabetes and obesity. Long-term studies are required to demonstrate that this combination will reduce weight and improve glycemia in patients.
- Received June 13, 2012.
- Accepted October 24, 2012.
- © 2013 by the American Diabetes Association.
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