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Background: Study has shown no significant differences in basal and postprandial plasma active glucagon-like peptide-1 (p-active GLP-1) levels following test meal (TM) between complication-and treatment-naïve non-obese Japanese patients with type 2 diabetes (T2DM) and controls. Methods:In non-obese Japanese patients with T2DM (n=23, group 1) and healthy individuals as control (n=13, group 2), blood levels of plasma glucose (PG), serum insulin (s-IRI), serum C-peptide (s-CPR) and p-active GLP-1 like substances (p-active GLP-1-S) were measured 0, 30, and 60 min after TM (520-560 kcal. 23% fat, 60% carbohydrate and 17% protein). HbA1c levels were also measured in the groups. Patients with mean of 9.2 years disease had various complications and treatment with diet, exercise and/or oral medical drugs except incretin-related drugs for hyperglycemia. Results:There was no significant difference in mean of sex, age, or BMI between groups. Means of HbA1c and basal and postprandial PG with area under curve (AUC), and HOMA-R were significantly higher in group 1 than in group 2. Means of HOMA-β and insulinogenic index after ingestion of TM were significantly lower in group 1 than in group 2. However, there were no significant differences in means of basal and postprandial with AUC levels of s-IRI, s-CPR and p-active GLP-1-S levels between groups.

Background: A secretion of plasma active GLP-1 (p-active GLP-1) after ingestion of breakfast test meal (TM) is decreased in obese European patients with type 2 diabetes mellitus (T2DM). However, there was no significant difference in pactive GLP-1 secretion following TM between obese Japanese patients with T2DM and controls. The findings indicate the difference may be due to different races or dietary's customs of subjects. Aims: We examined whether p-active GLP-1 is truly affected by TM in obese Japanese patients (n = 24, group 1) and obese controls (n = 12, group 2). Methods: Glucose (PG), insulin (s-IRI), C-peptide (s-CPR) and active GLP-1 like substances (p-active GLP-1-S) levels in blood were measured 0, 30 and 60 min after TM. Obese Japanese patients with mean 9 years of diabetes had micro-and macro-vascular disturbances and were treated with diet, exercise and/or oral drugs for hyperglycemia. Results: There was no significant difference in sex, age or BMI between groups. Means HbA1c and PG were significantly higher in group 1 than in group 2. There were no significant differences in means of basal s-IRI, HOMA-R and s-CPR between groups. However, means of HOMA-β, insulinogenic index, postprandial s-IRI, s-CPR and p-active GLP-1-S or p-active GLP-1-S/PG values after TM were significantly lower in group 1 than in group 2. Conclusions: These results indicate that a response of p-active GLP-1-S after TM in obese Japanese patients with T2DM was decreased and secretion of GLP-1 relative to PG was impaired. The method of enhancing function of active GLP-1 may be useful for treatment in some of patients with diabetes mellitus.

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