| Abstract: | Aim: To evaluate the dose–response relationship of the recombinant glucagon‐like peptide‐1 (7‐36) amide (rGLP‐1) administered by continuous subcutaneous infusion (CSCI) in subjects with type 2 diabetes, with respect to reductions in fasting, postprandial and 11‐h serum glucose profiles. Methods: In a double‐blind, parallel, placebo‐controlled trial, 47 patients were randomized to placebo or rGLP‐1 (1.25, 2.5, 5.0 or 8.5 pmol/kg/min) by CSCI for 7 days. On day 1 (pretreatment) and on day 8, patients underwent monitoring of fasting, postprandial, and 11‐h profiles of glucose and hormones. Results: Fasting serum glucose decreased by 76.2, 53.9, 37.0 and 22.7 mg/dl for the 8.5, 5.0, 2.5 and 1.25 pmol/kg/min rGLP‐1 groups, respectively, compared to a decrease of 1.1 mg/dl for placebo (p = 0.0002, 0.005, 0.064 and 0.27, respectively). Mean 11‐h serum glucose area under the curve decreased by 36.3, 23.3, 16.9 and 10.0% for 8.5, 5.0, 2.5 and 1.25 pmol/kg/min rGLP‐1, respectively, compared to no change for placebo (p = 0.0001, 0.0019, 0.012 and 0.14, respectively). Mean fasting C‐peptide increased dose dependently with rGLP‐1 (p = 0.0023 for the highest dose) and decreased with placebo. There were no serious safety concerns and no instances of hypoglycaemia. Conclusions: rGLP‐1 produced continuous improvements in glycaemic control across a broad dose range of up to 8.5 pmol/kg/min. |
