Antidiabetic drug therapy alleviates type 1 diabetes in mice by promoting pancreatic α-cell transdifferentiation

Dipak Sadashiv Sarnobat, Charlotte Moffett, Neil Tanday, Frank Reimann, Fiona Gribble, PR Flatt, Andrei Tarasov

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Gut incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), enhance secretion of insulin in a glucose-dependent manner, predominantly by elevating cytosolic levels of cAMP in pancreatic β-cells. Successful targeting of the incretin pathway by several drugs, however, suggests the antidiabetic mechanism is likely to span beyond the acute effect on hormone secretion and include, for instance, stimulation of β-cell growth and/or proliferation. Likewise, the antidiabetic action of kidney sodium-glucose linked transporter-2 (SGLT-2) inhibitors exceeds simple increase glucose excretion. Potential reasons for these ‘added benefits’ may lie in the long-term effects of these signals on developmental aspects of pancreatic islet cells. In this work, we explored if the incretin mimetics or SGLT-2 inhibitors can affect the size of the islet α- or β-cell compartments, under the condition of β-cell stress.
To that end, we utilised mice expressing YFP specifically in pancreatic α-cells, in which we modelled type 1 diabetes by injecting streptozotocin, followed by a 10-day administration of liraglutide, sitagliptin or dapagliflozin.
We observed an onset of diabetic phenotype, which was partially reversed by the administration of the antidiabetic drugs. The mechanism for the reversal included induction of β-cell proliferation, decrease in β-cell apoptosis and, for the incretin mimetics, transdifferentiation of α-cells into β-cells.
Our data therefore emphasize the role of chronic incretin signalling in induction of α-/β-cell transdifferentiation. We conclude that incretin peptides may act directly on islet cells, making use of the endogenous local sites of ‘ectopic’ expression, whereas SGLT-2 inhibitors work via protecting β-cells from chronic hyperglycaemia.
Original languageEnglish
Article number114216
Pages (from-to)1-10
Number of pages10
JournalBiochemical Pharmacology
Early online date11 Sept 2020
Publication statusPublished (in print/issue) - 31 Dec 2020

Bibliographical note

Funding Information:
These studies were supported in part by Young Investigator Award from Diabetes UK to CRM and Ulster University Vice-Chancellor Research Studentship award to DS. Research in the Reimann/Gribble laboratory is currently funded by the Wellcome Trust ( 106262/Z/14/Z and 106263/Z/14/Z ) and the MRC ( MRC_MC_UU_12012/3 ).

Publisher Copyright:
© 2020 Elsevier Inc.

Copyright 2020 Elsevier B.V., All rights reserved.


  • GLP-1 signalling
  • α/β-cell transdifferentiation
  • type 1 diabetes
  • apoptosis
  • glucagon
  • Glucagon
  • Type 1 diabetes
  • α/β-Cell transdifferentiation
  • Apoptosis


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