Medicine an Surgery notes

Apr 25th, 2015
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INCRETINS The incretins are hormones that work to increase insulin secretion. The incretin concept was developed when it was observed that there issubstantially more insulin secreted in response to oral glucose versus intravenousglucose. It was hypothesized that glucose in the digestive tract activated a feed-forwardmechanism that increased insulin secretion, anticipating the rise in blood glucosethat would occur following absorption of ingested carbohydrates. There are two main incretin hormones in humans;1) GIP (glucose-dependent insulinotropic peptide; also known as gastricinhibitory peptide)2) GLP-1 (glucagon-like peptide-1). Both hormones are secreted by endocrine cells that are located in the epithelium of thesmall intestine. Incretin hormone release is regulated in a similar way to other digestivetract hormones. An increase in the concentration of a substance in the lumen of the digestive tract (inthis case glucose) acts as the trigger for hormone secretion. Glucose in the small intestine stimulates incretin release. Incretins are carried through the circulation to their target tissue: the pancreatic betacells. Incretin stimulation of beta cells causes them to secrete more insulin in response to thesame amount of blood glucose. There has been a lot of interest in developing incretin-based therapies for thetreatment of type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, which is a

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