Thread by @omlakhani

#ClinicalPearl #MedTwitter

GLP-1 and GIP are both incretin hormones. Incretins are the X factor in the pathogenesis of type 2 diabetes and are a key component of the 'Ominous octet' - the 8 factors that cause type 2 diabetes. Contd..

But GLP-1 and GIP have subtle differences

GLP-1 inhibits insulin and also inhibits glucagon secretion

GIP on the other stimulates glucagon production in hypoglycemic situation and also stimulates insulin in hyperglycemic situation

DPP-IV inhibitors prevent the breakdown of both GLP-1 as well as GIP due to DPP-IV enzyme. Hence the half-life of these incretins is increased

In the situation of hypoglycemia, the increased half-life of GIP proves useful for glucagon secretion and hence preventing severe hypoglycemia

Hence DPP-IV inhibitors are not only useful in treatment of hyperglycemia (high sugars) but also prevent severe hypoglycemia (low sugars)

Understanding the actions of GIP is the next phase of understanding type 2 diabetes and developing therapeutics for the same.