Abstract
Background: Incretin hormones like glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are regulators of insulin and glucagon secretion, and thereby, glucose metabolism. The hormones also have other valuable antidiabetic actions, like decreased appetite and reduced gastric emptying, causing blood glucose levels to decrease. Their role in children with type 1 diabetes (T1D) is not well defined and evidence is scarce. The aim of this systematic review was to compare fasting and postprandial incretin levels in children and adolescents with T1D versus healthy controls and to assess their relationship with glycemic outcomes and disease duration in T1D.
Methods: A search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) identified 2694 studies, of which 10 met the inclusion criteria. Study quality was assessed using Joanna Briggs Institute (JBI) appraisal tools. Meta-analysis using a random effects model estimated pooled Hedges’ g and 95% prediction intervals (PIs) for incretin levels.
Results: The 10 included studies had moderate risk of bias and varied in design (sample sizes: 7–257). No consistent differences in GLP-1 levels were observed between T1D and healthy controls, except during ketoacidosis. Pooled fasting GLP-1 and GIP levels were 8.03 and 9.85 pmol/L, respectively; postprandial levels were 18.98 (GLP-1) and 44.79 pmol/L (GIP). We found a significant heterogeneity in study designs and measurement methods.
Conclusions: We found no significant difference in incretin levels between the three small and heterogeneous studies that compared T1D children to a healthy control group. A wide range of factors seems to influence the incretin levels in children with T1D. Disease duration, remission status, and meal size together with composition of nutrients in the meal were investigated in relation to GLP-1 and GIP levels in the included studies. Larger studies are needed to better understand the associations between incretin levels and metabolic outcomes in children and adolescents with T1D.
Methods: A search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) identified 2694 studies, of which 10 met the inclusion criteria. Study quality was assessed using Joanna Briggs Institute (JBI) appraisal tools. Meta-analysis using a random effects model estimated pooled Hedges’ g and 95% prediction intervals (PIs) for incretin levels.
Results: The 10 included studies had moderate risk of bias and varied in design (sample sizes: 7–257). No consistent differences in GLP-1 levels were observed between T1D and healthy controls, except during ketoacidosis. Pooled fasting GLP-1 and GIP levels were 8.03 and 9.85 pmol/L, respectively; postprandial levels were 18.98 (GLP-1) and 44.79 pmol/L (GIP). We found a significant heterogeneity in study designs and measurement methods.
Conclusions: We found no significant difference in incretin levels between the three small and heterogeneous studies that compared T1D children to a healthy control group. A wide range of factors seems to influence the incretin levels in children with T1D. Disease duration, remission status, and meal size together with composition of nutrients in the meal were investigated in relation to GLP-1 and GIP levels in the included studies. Larger studies are needed to better understand the associations between incretin levels and metabolic outcomes in children and adolescents with T1D.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 1633755 |
| Tidsskrift | Pediatric Diabetes |
| Vol/bind | 2025 |
| Udgave nummer | 1 |
| Antal sider | 12 |
| ISSN | 1399-543X |
| DOI | |
| Status | Udgivet - 2025 |