Diabetologia

Metabolic state influences how liraglutide boosts insulin release through the brain and pancreas

Updated

Abstract

Liraglutide (25 nmol/l) enhanced glucose-stimulated insulin secretion specifically in donors with glucose intolerance (n=7, p=0.021).

  • No effect on insulin secretion was observed in normoglycaemic islets (n=7), despite preserved responsiveness to GLP-1.
  • GLP-1 receptor mRNA levels decreased progressively with rising HbA levels, indicating a relationship with metabolic dysfunction (p=0.015).
  • In chow-fed mice, liraglutide's insulin-stimulating effects required tanycyte-mediated access to the hypothalamus, as shown in GLP-1R knockout mice.
  • During metabolic dysfunction induced by a 12-week high-fat diet, direct islet responsiveness to liraglutide was restored independently of tanycyte function.
  • In advanced metabolic disease (27-week high-fat diet), while islet responsiveness was maintained ex vivo, in vivo insulin enhancement was lost, suggesting alternative mechanisms for glucose lowering.

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Funding

Competing interests

Acknowledgements: This work was supported by the European Foundation for the Study of Diabetes/Lilly-2016 (to C. Bonner), the Société Francophone du Diabète 2015 (to C. Bonner), the Conseil Regional Nord-Pas de Calais (to C. Bonner), the European Consortium for Islet Transplantation funded by the Juvenile Diabetes Research Foundation (to J. Kerr-Conte and F. Pattou), European Genomic Institute for Diabetes grant ANR-10-LABX-0046 (to V. Prevot, F. Pattou and B. Staels), I-SITE ULNE grant ANR-16-IDEX-0004 (to V. Prevot, F. Pattou and B. Staels), European Research Council Synergy Grant 810331 (to V. Prevot, R. Nogueiras and M. Schwaninger), Agence National de la Recherche Grant ANR-15-CE14-0025 (to V. Prevot), Novo Nordisk A/S (to V. Prevot), H2020-MSCA Grant 748134 (to M. Imbernon), Agence Nationale de la Recherche Grant ANR-18-CE14-0007-01 ENDIABAC (to C. Knauf), the International Research Project Grant NeuroMicrobiota from Inserm (to C. Knauf), Medical Research Council grant MR/R010676/1 (to B. Jones), Diabetes UK grant 20/0006307 (to B. Jones) and the Imperial College London IPPRF scheme (to B. Jones). The Section of Endocrinology and Investigative Medicine at Imperial College London is supported by the NIHR Biomedical Research Centre Funding Scheme and the NIHR/Imperial Clinical Research Facility. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. We thank the islet isolation team at Lille University Hospital for providing human islets and acknowledge the technical assistance from the imaging core facility at Imperial College London. Data availability: All data generated or analysed during this study are included in the published article and its supplementary information files. Additional raw data, analytical methods and study materials are available from the corresponding authors upon reasonable request for 10 years after the publication of the data. Mouse models described in this study are available through material transfer agreements with the originating institutions. There will be no restriction to data sharing following publication, other than the necessary anonymisation of human data. Authors’ relationships and activities: CK is a co-founder of Enterosys SA (Labège, France). All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Contribution statement: CS, MI, VP and CB conceptualised and supervised the study. CS, MI, IL, ED, SC, ID, AA-M, MM-L, EW, LK, BP, FA, LZ, ND, JT, MM, GP, VG, FWP, RN, MS, PR, BS, JK-C, CK, BJ, FP, VP and CB contributed to the conception or design of the work, data acquisition, analysis or interpretation of data. All authors drafted the article or reviewed it critically for important intellectual content. All authors approved the final version of the manuscript. CB and VP are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
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