Die Bedeutung der Inkretinhormone GIP und GLP-1 für die Pathogenese des Typ-2-Diabetes[∗]

Zusammenfassung

Der Inkretineffekt, d. h. die postprandiale Verstärkung der Insulinsekretion durch gastrointestinale Hormone, ist bei stoffwechselgesunden Personen für ca. 50–70 % der Insulinanstiege nach Mahlzeiten verantwortlich. Bei Patienten mit Typ-2-Diabetes fehlt die Inkretinstimulation hingegen nahezu vollständig. Ursächlich basiert die Störung des Inkretineffektes beim Typ-2-Diabetes im Wesentlichen auf einer Einschränkung der insulinotropen Wirkung von GIP, wohingegen die Wirkung von GLP-1 weitestgehend erhalten ist. Zudem wurde diskutiert, ob Störungen der GLP-1 Sekretion eine Bedeutung für die mangelnde Inkretinstimulation beim Typ-2-Diabetes haben könnten. Allerdings konnte eine solche Verminderung der GLP-1 Freisetzung in der Mehrzahl der Studien bei Patienten mit Typ-2-Diabetes nicht bestätigt werden. In diesem Artikel wird die Freisetzung und Wirkung der Inkretinhor­mone GLP-1 und GIP bei Patienten mit Typ-2-Diabetes und gesunden Personen gegenübergestellt. Ferner werden die Störungen im Bereich der ­entero-insulären Achse hinsichtlich ihrer Bedeutung für die Pathogenese des Typ-2-Diabetes diskutiert.

1 anlässlich der Verleihung des Werner Creutzfeldt Preises 2009 der Deutschen Diabetes Gesellschaft

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1 anlässlich der Verleihung des Werner Creutzfeldt Preises 2009 der Deutschen Diabetes Gesellschaft