The Role of Glucagon in Glycemic Variability in Type 1 Diabetes: A Narrative Review

Abstract

Keyu Guo,* Qi Tian,* Lin Yang, Zhiguang Zhou National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lin Yang; Zhiguang Zhou Email [email protected]; [email protected]: Type 1 diabetes mellitus (T1DM) is a progressive disease as a result of the severe destruction of islet β-cell function, which leads to high glucose variability in patients. However, α-cell function is also compromised in patients with T1DM, characterized by aberrant fasting and postprandial glucagon secretion. According to recent studies, this aberrant glucagon secretion plays an increasing role in hyperglycemia, insulin-induced hypoglycemia and exercise-associated hypoglycemia in patients with T1DM. With application of continuous glucose monitoring system, dozens of metrics enable the assessment of glycemic variability, which is an integral component of glycemic control for patients with T1DM. There is growing evidences to illustrate the contribution of glucagon secretion to the glycemic variability in patients with T1DM, which may promote the development of new treatment strategies aiming to mitigate glycemic variability associated with aberrant glucagon secretion.Keywords: type 1 diabetes, glucagon secretion, continuous glucose monitoring, hyperglycemia, hypoglycemia, glycemic variability

Keywords

• type 1 diabetes
• glucagon secretion
• continuous glucose monitoring
• hyperglycemia
• hypoglycemia
• glycemic variability.