Metabolism of GIP and the contribution of GIP to the glucose-lowering properties of DPP-4 inhibitors

Carolyn F. Deacon*

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

20 Citations (Scopus)

Abstract

Glucose-dependent insulinotropic polypeptide (GIP) is a gastrointestinal hormone with insulinotropic and glucagonotropic actions, and is believed to be the more physiologically important incretin hormone in healthy humans. Together with the other incretin hormone, glucagon-like peptide-1 (GLP-1), it plays an important role in regulating glucose homeostasis. Both GLP-1 and GIP are substrates of the enzyme dipeptidyl peptidase-4 (DPP-4), and DPP-4 inhibitors, which potentiate their effects on glycaemic control, are now used to treat type 2 diabetes (T2D). This review describes how post-translational processing of the GIP precursor molecule and postrelease degradation of the secretory products give rise to multiple isoforms of GIP, some, but not all of which are biologically active, and discusses how this impacts upon their measurement by immunological- and bioassaybased methods. DPP-4 inhibitors reduce degradation of GIP, and although the insulinotropic effects of GIP are impaired in patients with T2D, they can be at least partially restored if glycaemic control is improved. Therefore, given that studies with incretin receptor antagonists indicate that not all of the glucose-lowering effects of DPP-4 inhibition can be accounted for by GLP-1 alone, evidence supports the notion that GIP may play a role in mediating the anti-hyperglycaemic effects of DPP-4 inhibition, while its glucagonotropic actions at lower glucose levels may contribute to the low risk of hypoglycaemia associated with DPP-4 inhibitors.

Original languageEnglish
Article number170196
JournalPeptides
Volume125
Number of pages7
ISSN0196-9781
DOIs
Publication statusPublished - 2020

Keywords

  • Dipeptidyl peptidase-4
  • Glucose-dependent insulinotropic polypeptide
  • Incretin
  • Peptide degradation
  • Therapy
  • Type 2 diabetes
  • DEPENDENT INSULINOTROPIC POLYPEPTIDE
  • GLUCAGON-LIKE PEPTIDE-1
  • IV-RESISTANT
  • NEUTRAL ENDOPEPTIDASE-24.11
  • RECEPTOR EXPRESSION
  • INCRETIN HORMONES
  • 7-36 AMIDE
  • IN-VITRO
  • SECRETION
  • DEGRADATION

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