Skip to main content
Top
Published in: Diabetologia 12/2008

01-12-2008 | Article

Glucagon-like peptide-1, but not glucose-dependent insulinotropic peptide, inhibits glucagon secretion via somatostatin (receptor subtype 2) in the perfused rat pancreas

Authors: J. de Heer, C. Rasmussen, D. H. Coy, J. J. Holst

Published in: Diabetologia | Issue 12/2008

Login to get access

Abstract

Aims/hypothesis

The glucose-lowering effect of glucagon-like peptide-1 (GLP-1) is based not only upon its potent insulinotropic actions but also on its ability to restrain glucagon secretion. Surprisingly, the closely related glucose-dependent insulinotropic peptide (GIP) stimulates glucagon release. We examined whether the islet hormone somatostatin, which strongly inhibits glucagon secretion, is involved in this divergent behaviour.

Methods

At 1.5 mmol/l glucose and therefore minimal insulin secretion, the glucagon, insulin and somatostatin responses to 20 mmol/l glucose, GLP-1, GIP and somatostatin were studied in the presence of a high-affinity monoclonal somatostatin antibody and of a highly specific somatostatin receptor subtype 2 (SSTR2) antagonist (PRL-2903) in the isolated perfused rat pancreas.

Results

In control experiments, GLP-1 at 1 and 10 nmol/l reduced glucagon secretion significantly to 59.0 ± 6.3% (p < 0.004; n = 5; SSTR2 series; each vs pre-infusion level) and to 48.0 ± 2.6% (p < 0.001; n = 6; somatostatin antibody series) respectively. During somatostatin antibody administration, GLP-1 still inhibited glucagon secretion significantly, but the effect was less pronounced than in control experiments (p < 0.018). Co-infusion of the SSTR2 antagonist completely abolished the GLP-1-induced suppression of glucagon secretion. In contrast, neither the GIP-induced stimulation of glucagon release nor its inhibition by 20 mmol/l glucose was altered by somatostatin antibody or SSTR2 antagonist administration.

Conclusions/interpretation

We conclude that GLP-1 is capable of inhibiting glucagon secretion even in the absence of secretory products from the beta cell. It is highly likely that this is mediated via somatostatin interacting with SSTR2 on rat alpha cells. In contrast, GIP and glucose seem to influence the alpha cell independently of somatostatin secretion.
Literature
2.
go back to reference Nauck MA, Kleine N, Orskov C, Holst JJ, Willms B, Creutzfeldt W (1993) Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 36:741–744PubMedCrossRef Nauck MA, Kleine N, Orskov C, Holst JJ, Willms B, Creutzfeldt W (1993) Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 36:741–744PubMedCrossRef
3.
go back to reference Meier JJ, Gallwitz B, Siepmann N et al (2003) Gastric inhibitory polypeptide (GIP) dose-dependently stimulates glucagon secretion in healthy human subjects at euglycaemia. Diabetologia 46:798–801PubMedCrossRef Meier JJ, Gallwitz B, Siepmann N et al (2003) Gastric inhibitory polypeptide (GIP) dose-dependently stimulates glucagon secretion in healthy human subjects at euglycaemia. Diabetologia 46:798–801PubMedCrossRef
4.
go back to reference Pederson RA, Brown JC (1978) Interaction of gastric inhibitory polypeptide, glucose, and arginine on insulin and glucagon secretion from the perfused rat pancreas. Endocrinology 103:610–615PubMedCrossRef Pederson RA, Brown JC (1978) Interaction of gastric inhibitory polypeptide, glucose, and arginine on insulin and glucagon secretion from the perfused rat pancreas. Endocrinology 103:610–615PubMedCrossRef
5.
go back to reference Shah P, Vella A, Basu A, Basu R, Schwenk WF, Rizza RA (2000) Lack of suppression of glucagon contributes to postprandial hyperglycemia in subjects with type 2 diabetes mellitus. J Clin Endocrinol Metab 85:4053–4059PubMedCrossRef Shah P, Vella A, Basu A, Basu R, Schwenk WF, Rizza RA (2000) Lack of suppression of glucagon contributes to postprandial hyperglycemia in subjects with type 2 diabetes mellitus. J Clin Endocrinol Metab 85:4053–4059PubMedCrossRef
6.
go back to reference Maruyama H, Hisatomi A, Orci L, Grodsky GM, Unger RH (1984) Insulin within islets is a physiologic glucagon release inhibitor. J Clin Invest 74:2296–2299PubMedCrossRef Maruyama H, Hisatomi A, Orci L, Grodsky GM, Unger RH (1984) Insulin within islets is a physiologic glucagon release inhibitor. J Clin Invest 74:2296–2299PubMedCrossRef
7.
go back to reference Ishihara H, Maechler P, Gjinovci A, Herrera PL, Wollheim CB (2003) Islet beta-cell secretion determines glucagon release from neighbouring alpha-cells. Nat Cell Biol 5:330–335PubMedCrossRef Ishihara H, Maechler P, Gjinovci A, Herrera PL, Wollheim CB (2003) Islet beta-cell secretion determines glucagon release from neighbouring alpha-cells. Nat Cell Biol 5:330–335PubMedCrossRef
8.
go back to reference Wendt A, Birnir B, Buschard K et al (2004) Glucose inhibition of glucagon secretion from rat alpha-cells is mediated by GABA released from neighboring beta-cells. Diabetes 53:1038–1045PubMedCrossRef Wendt A, Birnir B, Buschard K et al (2004) Glucose inhibition of glucagon secretion from rat alpha-cells is mediated by GABA released from neighboring beta-cells. Diabetes 53:1038–1045PubMedCrossRef
9.
go back to reference Cejvan K, Coy DH, Efendic S (2003) Intra-islet somatostatin regulates glucagon release via type 2 somatostatin receptors in rats. Diabetes 52:1176–1181PubMedCrossRef Cejvan K, Coy DH, Efendic S (2003) Intra-islet somatostatin regulates glucagon release via type 2 somatostatin receptors in rats. Diabetes 52:1176–1181PubMedCrossRef
10.
go back to reference Franklin I, Gromada J, Gjinovci A, Theander S, Wollheim CB (2005) Beta-cell secretory products activate alpha-cell ATP-dependent potassium channels to inhibit glucagon release. Diabetes 54:1808–1815PubMedCrossRef Franklin I, Gromada J, Gjinovci A, Theander S, Wollheim CB (2005) Beta-cell secretory products activate alpha-cell ATP-dependent potassium channels to inhibit glucagon release. Diabetes 54:1808–1815PubMedCrossRef
11.
go back to reference Moens K, Heimberg H, Flamez D et al (1996) Expression and functional activity of glucagon, glucagon-like peptide I, and glucose-dependent insulinotropic peptide receptors in rat pancreatic islet cells. Diabetes 45:257–261PubMedCrossRef Moens K, Heimberg H, Flamez D et al (1996) Expression and functional activity of glucagon, glucagon-like peptide I, and glucose-dependent insulinotropic peptide receptors in rat pancreatic islet cells. Diabetes 45:257–261PubMedCrossRef
12.
go back to reference Heller RS, Kieffer TJ, Habener JF (1997) Insulinotropic glucagon-like peptide I receptor expression in glucagon-producing alpha-cells of the rat endocrine pancreas. Diabetes 46:785–791PubMedCrossRef Heller RS, Kieffer TJ, Habener JF (1997) Insulinotropic glucagon-like peptide I receptor expression in glucagon-producing alpha-cells of the rat endocrine pancreas. Diabetes 46:785–791PubMedCrossRef
13.
go back to reference Gromada J, Holst JJ, Rorsman P (1998) Cellular regulation of islet hormone secretion by the incretin hormone glucagon-like peptide 1. Pflugers Arch 435:583–594PubMedCrossRef Gromada J, Holst JJ, Rorsman P (1998) Cellular regulation of islet hormone secretion by the incretin hormone glucagon-like peptide 1. Pflugers Arch 435:583–594PubMedCrossRef
14.
go back to reference Fehmann HC, Goke R, Goke B (1995) Cell and molecular biology of the incretin hormones glucagon-like peptide-I and glucose-dependent insulin releasing polypeptide. Endocr Rev 16:390–410PubMedCrossRef Fehmann HC, Goke R, Goke B (1995) Cell and molecular biology of the incretin hormones glucagon-like peptide-I and glucose-dependent insulin releasing polypeptide. Endocr Rev 16:390–410PubMedCrossRef
15.
go back to reference Alberti KG, Christensen NJ, Christensen SE et al (1973) Inhibition of insulin secretion by somatostatin. Lancet 2:1299–1301PubMedCrossRef Alberti KG, Christensen NJ, Christensen SE et al (1973) Inhibition of insulin secretion by somatostatin. Lancet 2:1299–1301PubMedCrossRef
16.
go back to reference Koerker DJ, Ruch W, Chideckel E et al (1974) Somatostatin: hypothalamic inhibitor of the endocrine pancreas. Science 184:482–484PubMedCrossRef Koerker DJ, Ruch W, Chideckel E et al (1974) Somatostatin: hypothalamic inhibitor of the endocrine pancreas. Science 184:482–484PubMedCrossRef
17.
go back to reference Samols E, Stagner JI, Ewart RB, Marks V (1988) The order of islet microvascular cellular perfusion is B-A-D in the perfused rat pancreas. J Clin Invest 82:350–353PubMedCrossRef Samols E, Stagner JI, Ewart RB, Marks V (1988) The order of islet microvascular cellular perfusion is B-A-D in the perfused rat pancreas. J Clin Invest 82:350–353PubMedCrossRef
18.
go back to reference Samols E, Stagner JI (1990) Islet somatostatin–microvascular, paracrine, and pulsatile regulation. Metabolism 39:55–60PubMedCrossRef Samols E, Stagner JI (1990) Islet somatostatin–microvascular, paracrine, and pulsatile regulation. Metabolism 39:55–60PubMedCrossRef
19.
go back to reference Stagner JI, Samols E (1992) The vascular order of islet cellular perfusion in the human pancreas. Diabetes 41:93–97PubMedCrossRef Stagner JI, Samols E (1992) The vascular order of islet cellular perfusion in the human pancreas. Diabetes 41:93–97PubMedCrossRef
20.
21.
go back to reference Kumar U, Sasi R, Suresh S et al (1999) Subtype-selective expression of the five somatostatin receptors (hSSTR1-5) in human pancreatic islet cells: a quantitative double-label immunohistochemical analysis. Diabetes 48:77–85PubMedCrossRef Kumar U, Sasi R, Suresh S et al (1999) Subtype-selective expression of the five somatostatin receptors (hSSTR1-5) in human pancreatic islet cells: a quantitative double-label immunohistochemical analysis. Diabetes 48:77–85PubMedCrossRef
22.
go back to reference Ludvigsen E, Olsson R, Stridsberg M, Janson ET, Sandler S (2004) Expression and distribution of somatostatin receptor subtypes in the pancreatic islets of mice and rats. J Histochem Cytochem 52:391–400PubMed Ludvigsen E, Olsson R, Stridsberg M, Janson ET, Sandler S (2004) Expression and distribution of somatostatin receptor subtypes in the pancreatic islets of mice and rats. J Histochem Cytochem 52:391–400PubMed
23.
go back to reference Rossowski WJ, Coy DH (1994) Specific inhibition of rat pancreatic insulin or glucagon release by receptor-selective somatostatin analogs. Biochem Biophys Res Commun 205:341–346PubMedCrossRef Rossowski WJ, Coy DH (1994) Specific inhibition of rat pancreatic insulin or glucagon release by receptor-selective somatostatin analogs. Biochem Biophys Res Commun 205:341–346PubMedCrossRef
24.
go back to reference Strowski MZ, Parmar RM, Blake AD, Schaeffer JM (2000) Somatostatin inhibits insulin and glucagon secretion via two receptors subtypes: an in vitro study of pancreatic islets from somatostatin receptor 2 knockout mice. Endocrinology 141:111–117PubMedCrossRef Strowski MZ, Parmar RM, Blake AD, Schaeffer JM (2000) Somatostatin inhibits insulin and glucagon secretion via two receptors subtypes: an in vitro study of pancreatic islets from somatostatin receptor 2 knockout mice. Endocrinology 141:111–117PubMedCrossRef
25.
go back to reference Singh V, Brendel MD, Zacharias S et al (2007) Characterization of somatostatin receptor subtype-specific regulation of insulin and glucagon secretion: an in vitro study on isolated human pancreatic islets. J Clin Endocrinol Metab 92:673–680PubMedCrossRef Singh V, Brendel MD, Zacharias S et al (2007) Characterization of somatostatin receptor subtype-specific regulation of insulin and glucagon secretion: an in vitro study on isolated human pancreatic islets. J Clin Endocrinol Metab 92:673–680PubMedCrossRef
26.
go back to reference Holst JJ, Jorgensen PN, Rasmussen TN, Schmidt P (1992) Somatostatin restraint of gastrin secretion in pigs revealed by monoclonal antibody immunoneutralization. Am J Physiol 263:G908–G912PubMed Holst JJ, Jorgensen PN, Rasmussen TN, Schmidt P (1992) Somatostatin restraint of gastrin secretion in pigs revealed by monoclonal antibody immunoneutralization. Am J Physiol 263:G908–G912PubMed
27.
go back to reference Hocart SJ, Jain R, Murphy WA, Taylor JE, Coy DH (1999) Highly potent cyclic disulfide antagonists of somatostatin. J Med Chem 42:1863–1871PubMedCrossRef Hocart SJ, Jain R, Murphy WA, Taylor JE, Coy DH (1999) Highly potent cyclic disulfide antagonists of somatostatin. J Med Chem 42:1863–1871PubMedCrossRef
28.
go back to reference Ipp E, Dobbs RE, Harris V, Arimura A, Vale W, Unger RH (1977) The effects of gastrin, gastric inhibitory polypeptide, secretin, and the octapeptide of cholecystokinin upon immunoreactive somatostatin release by the perfused canine pancreas. J Clin Invest 60:1216–1219PubMedCrossRef Ipp E, Dobbs RE, Harris V, Arimura A, Vale W, Unger RH (1977) The effects of gastrin, gastric inhibitory polypeptide, secretin, and the octapeptide of cholecystokinin upon immunoreactive somatostatin release by the perfused canine pancreas. J Clin Invest 60:1216–1219PubMedCrossRef
29.
go back to reference Pederson RA (1994) Gastric inhibitory polypeptide. In: Walsh J, Dockray G (eds) Gut peptides: biochemistry and physiology. Raven Press, New York, pp 217–259 Pederson RA (1994) Gastric inhibitory polypeptide. In: Walsh J, Dockray G (eds) Gut peptides: biochemistry and physiology. Raven Press, New York, pp 217–259
30.
go back to reference Szecowka J, Grill V, Sandberg E, Efendic S (1982) Effect of GIP on the secretion of insulin and somatostatin and the accumulation of cyclic AMP in vitro in the rat. Acta Endocrinol (Copenh) 99:416–421 Szecowka J, Grill V, Sandberg E, Efendic S (1982) Effect of GIP on the secretion of insulin and somatostatin and the accumulation of cyclic AMP in vitro in the rat. Acta Endocrinol (Copenh) 99:416–421
31.
go back to reference Efendic S, Enzmann F, Nylen A, Uvnas-Wallensten K, Luft R (1979) Effect of glucose/sulfonylurea interaction on release of insulin, glucagon, and somatostatin from isolated perfused rat pancreas. Proc Natl Acad Sci USA 76:5901–5904PubMedCrossRef Efendic S, Enzmann F, Nylen A, Uvnas-Wallensten K, Luft R (1979) Effect of glucose/sulfonylurea interaction on release of insulin, glucagon, and somatostatin from isolated perfused rat pancreas. Proc Natl Acad Sci USA 76:5901–5904PubMedCrossRef
32.
go back to reference Zhang Q, Bengtsson M, Partridge C et al (2007) R-type Ca(2+)-channel-evoked CICR regulates glucose-induced somatostatin secretion. Nat Cell Biol 9:453–460PubMedCrossRef Zhang Q, Bengtsson M, Partridge C et al (2007) R-type Ca(2+)-channel-evoked CICR regulates glucose-induced somatostatin secretion. Nat Cell Biol 9:453–460PubMedCrossRef
33.
go back to reference de Heer J, Holst JJ (2007) Sulfonylurea compounds uncouple the glucose dependence of the insulinotropic effect of glucagon-like peptide 1. Diabetes 56:438–443PubMedCrossRef de Heer J, Holst JJ (2007) Sulfonylurea compounds uncouple the glucose dependence of the insulinotropic effect of glucagon-like peptide 1. Diabetes 56:438–443PubMedCrossRef
34.
go back to reference Rossowski WJ, Cheng BL, Jiang NY, Coy DH (1998) Examination of somatostatin involvement in the inhibitory action of GIP, GLP-1, amylin and adrenomedullin on gastric acid release using a new SRIF antagonist analogue. Br J Pharmacol 125:1081–1087PubMedCrossRef Rossowski WJ, Cheng BL, Jiang NY, Coy DH (1998) Examination of somatostatin involvement in the inhibitory action of GIP, GLP-1, amylin and adrenomedullin on gastric acid release using a new SRIF antagonist analogue. Br J Pharmacol 125:1081–1087PubMedCrossRef
35.
go back to reference Brand CL, Jorgensen PN, Knigge U et al (1995) Role of glucagon in maintenance of euglycemia in fed and fasted rats. Am J Physiol 269:E469–E477PubMed Brand CL, Jorgensen PN, Knigge U et al (1995) Role of glucagon in maintenance of euglycemia in fed and fasted rats. Am J Physiol 269:E469–E477PubMed
36.
go back to reference Orskov C, Jeppesen J, Madsbad S, Holst JJ (1991) Proglucagon products in plasma of noninsulin-dependent diabetics and nondiabetic controls in the fasting state and after oral glucose and intravenous arginine. J Clin Invest 87:415–423PubMedCrossRef Orskov C, Jeppesen J, Madsbad S, Holst JJ (1991) Proglucagon products in plasma of noninsulin-dependent diabetics and nondiabetic controls in the fasting state and after oral glucose and intravenous arginine. J Clin Invest 87:415–423PubMedCrossRef
37.
go back to reference Baldissera FG, Munoz-Perez MA, Holst JJ (1983) Somatostatin 1-28 circulates in human plasma. Regul Pept 6:63–69PubMedCrossRef Baldissera FG, Munoz-Perez MA, Holst JJ (1983) Somatostatin 1-28 circulates in human plasma. Regul Pept 6:63–69PubMedCrossRef
38.
go back to reference Hilsted L, Holst JJ (1982) On the accuracy of radioimmunological determination of somatostatin in plasma. Regul Pept 4:13–31PubMedCrossRef Hilsted L, Holst JJ (1982) On the accuracy of radioimmunological determination of somatostatin in plasma. Regul Pept 4:13–31PubMedCrossRef
39.
go back to reference Piqueras L, Tache Y, Martinez V (2003) Somatostatin receptor type 2 mediates bombesin-induced inhibition of gastric acid secretion in mice. J Physiol 549:889–901PubMedCrossRef Piqueras L, Tache Y, Martinez V (2003) Somatostatin receptor type 2 mediates bombesin-induced inhibition of gastric acid secretion in mice. J Physiol 549:889–901PubMedCrossRef
40.
go back to reference Goodman JW, Wang AC (1980) Immunoglobulins: structure, diversity and genetics. In: Fudenberg HH, Stites DP, Caldwell JL, Wells JV (eds) Basic and clinical immunology, 3rd edn. Lange Medical Publications, Los Altos, pp 28–43 Goodman JW, Wang AC (1980) Immunoglobulins: structure, diversity and genetics. In: Fudenberg HH, Stites DP, Caldwell JL, Wells JV (eds) Basic and clinical immunology, 3rd edn. Lange Medical Publications, Los Altos, pp 28–43
41.
go back to reference Hart TK, Pino RM (1986) Capillary permeability in the pancreas and colon: restriction of exogenous and endogenous molecules by fenestrated endothelia. Am J Anat 175:49–58PubMedCrossRef Hart TK, Pino RM (1986) Capillary permeability in the pancreas and colon: restriction of exogenous and endogenous molecules by fenestrated endothelia. Am J Anat 175:49–58PubMedCrossRef
42.
go back to reference Kvietys PR, Perry MA, Granger DN (1983) Permeability of pancreatic capillaries to small molecules. Am J Physiol 245:G519–G524PubMed Kvietys PR, Perry MA, Granger DN (1983) Permeability of pancreatic capillaries to small molecules. Am J Physiol 245:G519–G524PubMed
43.
go back to reference Brunicardi FC, Kleinman R, Moldovan S et al (2001) Immunoneutralization of somatostatin, insulin, and glucagon causes alterations in islet cell secretion in the isolated perfused human pancreas. Pancreas 23:302–308PubMedCrossRef Brunicardi FC, Kleinman R, Moldovan S et al (2001) Immunoneutralization of somatostatin, insulin, and glucagon causes alterations in islet cell secretion in the isolated perfused human pancreas. Pancreas 23:302–308PubMedCrossRef
44.
go back to reference Cabrera O, Jacques-Silva MC, Speier S et al (2008) Glutamate is a positive autocrine signal for glucagon release. Cell Metab 7:545–554PubMedCrossRef Cabrera O, Jacques-Silva MC, Speier S et al (2008) Glutamate is a positive autocrine signal for glucagon release. Cell Metab 7:545–554PubMedCrossRef
45.
go back to reference Weir GC, Bonner-Weir S (1990) Islets of Langerhans: the puzzle of intraislet interactions and their relevance to diabetes. J Clin Invest 85:983–987PubMedCrossRef Weir GC, Bonner-Weir S (1990) Islets of Langerhans: the puzzle of intraislet interactions and their relevance to diabetes. J Clin Invest 85:983–987PubMedCrossRef
46.
go back to reference Patton GS, Ipp E, Dobbs RE, Orci L, Vale W, Unger RH (1977) Pancreatic immunoreactive somatostatin release. Proc Natl Acad Sci USA 74:2140–2143PubMedCrossRef Patton GS, Ipp E, Dobbs RE, Orci L, Vale W, Unger RH (1977) Pancreatic immunoreactive somatostatin release. Proc Natl Acad Sci USA 74:2140–2143PubMedCrossRef
47.
go back to reference Barg S, Galvanovskis J, Gopel SO, Rorsman P, Eliasson L (2000) Tight coupling between electrical activity and exocytosis in mouse glucagon-secreting alpha-cells. Diabetes 49:1500–1510PubMedCrossRef Barg S, Galvanovskis J, Gopel SO, Rorsman P, Eliasson L (2000) Tight coupling between electrical activity and exocytosis in mouse glucagon-secreting alpha-cells. Diabetes 49:1500–1510PubMedCrossRef
48.
go back to reference Gromada J, Ma X, Hoy M et al (2004) ATP-sensitive K+ channel-dependent regulation of glucagon release and electrical activity by glucose in wild-type and SUR1−/− mouse alpha-cells. Diabetes 53(Suppl 3):S181–S189PubMedCrossRef Gromada J, Ma X, Hoy M et al (2004) ATP-sensitive K+ channel-dependent regulation of glucagon release and electrical activity by glucose in wild-type and SUR1−/− mouse alpha-cells. Diabetes 53(Suppl 3):S181–S189PubMedCrossRef
49.
go back to reference MacDonald PE, De Marinis YZ, Ramracheya R et al (2007) A K ATP channel-dependent pathway within alpha cells regulates glucagon release from both rodent and human islets of Langerhans. PLoS Biol 5:e143PubMedCrossRef MacDonald PE, De Marinis YZ, Ramracheya R et al (2007) A K ATP channel-dependent pathway within alpha cells regulates glucagon release from both rodent and human islets of Langerhans. PLoS Biol 5:e143PubMedCrossRef
50.
go back to reference Vieira E, Salehi A, Gylfe E (2007) Glucose inhibits glucagon secretion by a direct effect on mouse pancreatic alpha cells. Diabetologia 50:370–379PubMedCrossRef Vieira E, Salehi A, Gylfe E (2007) Glucose inhibits glucagon secretion by a direct effect on mouse pancreatic alpha cells. Diabetologia 50:370–379PubMedCrossRef
Metadata
Title
Glucagon-like peptide-1, but not glucose-dependent insulinotropic peptide, inhibits glucagon secretion via somatostatin (receptor subtype 2) in the perfused rat pancreas
Authors
J. de Heer
C. Rasmussen
D. H. Coy
J. J. Holst
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 12/2008
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-1149-y

Other articles of this Issue 12/2008

Diabetologia 12/2008 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.