Liu LR, Luo YY, Su PZ, Zhang C, Li ZT. Intestinal glucagon-like peptide-1: A new regulator of impaired counterregulatory responses to hypoglycemia in type 1 diabetes mellitus. World J Diabetes 2025; 16(1): 99726 [DOI: 10.4239/wjd.v16.i1.99726]
Corresponding Author of This Article
Cong Zhang, MD, PhD, Department of Gastroenterology, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan 528000, Guangdong Province, China. zhangc57@mail2.sysu.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jan 15, 2025; 16(1): 99726 Published online Jan 15, 2025. doi: 10.4239/wjd.v16.i1.99726
Intestinal glucagon-like peptide-1: A new regulator of impaired counterregulatory responses to hypoglycemia in type 1 diabetes mellitus
Le-Rong Liu, Yuan-Yuan Luo, Pei-Zhu Su, Cong Zhang, Zhao-Tao Li
Le-Rong Liu, Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Yuan-Yuan Luo, Department of Endocrinology, Chongqing University Three Gorges Hospital, Chongqing 404100, China
Yuan-Yuan Luo, Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404100, China
Yuan-Yuan Luo, Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400013, China
Pei-Zhu Su, Cong Zhang, Zhao-Tao Li, Department of Gastroenterology, The First People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
Co-first authors: Le-Rong Liu and Yuan-Yuan Luo.
Co-corresponding authors: Cong Zhang and Zhao-Tao Li.
Author contributions: Liu LR and Luo YY designed the manuscript outline and contributed to writing the manuscript; Su PZ contributed to revising the manuscript; Zhang C and Li ZT designed the overall concept of the manuscript and revised the draft; All the authors have read and approved the final manuscript. Liu LR and Luo YY have made crucial and indispensable contributions towards the completion of this manuscript and thus qualified as the co-first authors of the paper. Both Zhang C and Li ZT have played important and indispensable roles in the paper design, data interpretation and manuscript revising as the co-corresponding authors.
Supported bythe National Natural Science Foundation of China, No. 82400966; Guangdong Basic and Applied Basic Research Foundation, No. 2021A1515111025; and Science and Technology Projects in Guangzhou, No. 2024A04J5170.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cong Zhang, MD, PhD, Department of Gastroenterology, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan 528000, Guangdong Province, China. zhangc57@mail2.sysu.edu.cn
Received: July 30, 2024 Revised: September 19, 2024 Accepted: October 16, 2024 Published online: January 15, 2025 Processing time: 123 Days and 2.8 Hours
Abstract
In this article, we review the study by Jin et al, which examined the role of intestinal glucagon-like peptide-1 (GLP-1) in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus (T1DM). With the global rise of T1DM, there is an increased burden on society and healthcare systems. Due to insulin therapy and islet dysfunction, T1DM patients are highly vulnerable to severe hypoglycemia, a leading cause of mortality. In healthy individuals, counterregulatory mechanisms restore blood glucose during hypoglycemia, but repeated episodes impair these responses. Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia, leading to counterregulatory dysfunction. These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.
Core Tip: Jin et al reported that excessive intestinal glucagon-like peptide-1 (GLP-1) exacerbates impaired counterregulatory responses in individuals with type 1 diabetes mellitus (T1DM). By elucidating the molecular mechanisms through which GLP-1 disrupts the sympathetic-adrenal reflex and inhibits glucagon secretion, the authors explored the significant role of GLP-1 in counterregulatory failure. Further research is needed to understand the potential impact of GLP-1 and its analogs on counterregulatory responses in T1DM patients and to evaluate their prospects as adjunctive treatments for preventing and treating hypoglycemia in patients with diabetes.
