ISSN 1849-9031 (Online)

ISSN 1849-8922    (Print)

The emerging role of incretins in the pathophysiology of insulin resistance in type 1 diabetes.
Gorana Mirošević, Kristina Blaslov, Fran Naranđa, Mihovil Plećko, Jelena Marinković Radošević, Milan Vrkljan.


The pathophysiology of insulin resistance (IR) comprises a complex adipokine-mediated crosstalk between white adipose tissue and other organs. Although it is a prominent feature of Type 2 diabetes, a certain degree of IR also exists in Type 1 diabetes mellitus (T1DM). Incretins are gut derived hormones secreted into the circulation in response to nutrient ingestion that enhances glucose-stimulated insulin secretion. One of the main incretin hormones is glucagon-like peptide-1. It is degraded by dipeptidyl peptidase-4 (DPP-4) minutes after secretion. The diminished “incretin effect” is recognized as a part of prediabetes, usually associated with IR. DPP-4, as a part of the incretin system, has recently been proposed as a novel adipokine linked to IR and DPP-4 activity is higher in T1DM patients compared to healthy controls; furthermore, it correlates with the degree of IR. The role of the incretin system, with special emphasis on DPP-4, merits further evaluation because it might offer an insulin add-on therapeutic approach in the metabolic control of T1DM.