Long-term treatment with
glucagon-like peptide (GLP)-1 or its analog can improve
insulin sensitivity. However, continuous administration is required due to its short half-life. We hypothesized that continuous production of therapeutic levels of
GLP-1 in vivo by a gene
therapy strategy may remit
hyperglycemia and maintain prolonged normoglycemia. We produced a recombinant adenovirus expressing
GLP-1 (rAd-GLP-1) under the cytomegalovirus promoter, intravenously injected it into diabetic ob/ob mice, and investigated the effect of this treatment on remission of diabetes, as well as the mechanisms involved. rAd-GLP-1-treated diabetic ob/ob mice became normoglycemic 4 days
after treatment, remained normoglycemic over 60 days, and had reduced
body weight gain.
Glucose tolerance tests found that exogenous
glucose was cleared normally. rAd-GLP-1-treated diabetic ob/ob mice showed improved beta-cell function, evidenced by
glucose-responsive
insulin release, and increased
insulin sensitivity, evidenced by improved
insulin tolerance and increased
insulin-stimulated
glucose uptake in adipocytes. rAd-GLP-1 treatment increased basal levels of
insulin receptor substrate (IRS)-1 in the liver and activation of IRS-1 and
protein kinase C by
insulin in liver and muscle; increased Akt activation was only observed in muscle. rAd-GLP-1 treatment reduced hepatic
glucose production and hepatic expression of
phosphoenolpyruvate carboxykinase,
glucose-6-phosphatase, and
fatty acid synthase in ob/ob mice. Taken together, these results show that a single administration of rAd-GLP-1 results in the long-term remission of diabetes in ob/ob mice by improving
insulin sensitivity through restoration of
insulin signaling and reducing hepatic gluconeogenesis.