From the Guidelines
GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) are both incretin hormones that help regulate blood glucose levels, but they have important differences, with GLP-1 being more clinically significant and forming the basis for many diabetes medications. The key differences between GIP and GLP-1 lie in their effects on insulin secretion, glucagon suppression, gastric emptying, and satiety.
- GLP-1 strongly stimulates insulin secretion, suppresses glucagon, delays gastric emptying, and promotes satiety, making it effective for both diabetes management and weight loss 1.
- GIP primarily stimulates insulin secretion but has less effect on glucagon suppression and gastric emptying, and it may also promote fat storage, unlike GLP-1 1. Both hormones are released after meals, with GIP primarily from K-cells in the upper small intestine and GLP-1 from L-cells in the lower intestine. While GLP-1-based medications are widely used, dual GIP/GLP-1 receptor agonists like tirzepatide (Mounjaro) have recently been developed to harness the complementary effects of both hormones for enhanced glycemic control and weight management 1. The use of these medications should be prioritized based on their beneficial effects on weight and glycemic control, as well as their potential to reduce cardiovascular risk 1. In clinical practice, the choice of medication should be individualized based on patient factors, including comorbidities, kidney function, and costs 1. Overall, understanding the differences between GIP and GLP-1 is crucial for the effective management of diabetes and related conditions.
From the Research
Difference between Gastric Inhibitory Polypeptide (GIP) and Glucagon-Like Peptide (GLP)
- Gastric Inhibitory Polypeptide (GIP) and Glucagon-Like Peptide (GLP) are both incretin hormones that play a role in glucose regulation 2
- GLP-1 receptor agonists have been extensively studied and are currently used in the treatment of type 2 diabetes, with several agents available, including exenatide, liraglutide, albiglutide, dulaglutide, and lixisenatide 3, 4, 5, 6
- GIP, on the other hand, has been less studied, but dual GIP/GLP-1 receptor agonists are being explored as a potential treatment for type 2 diabetes 2
- The combination of SGLT2i with GLP-1-based therapies, including dual GIP/GLP-1 RA, addresses complementary pathophysiological mechanisms and enhances efficacy in achieving target haemoglobin A1C (HbA1c) levels 2
Mechanism of Action
- GLP-1 receptor agonists increase insulin secretion and reduce glucagon secretion in a glucose-dependent manner, posing a relatively low hypoglycemia risk 3, 4, 5, 6
- GLP-1 receptor agonists also offer weight-loss benefits and improve cardiovascular risk factors, including blood pressure, lipid parameters, and inflammatory markers 3, 4, 5, 6
- Dual GIP/GLP-1 receptor agonists may have a more pronounced effect on glucose regulation and weight loss, but more research is needed to fully understand their mechanism of action 2
Clinical Use
- GLP-1 receptor agonists are recommended as the preferred first injectable glucose-lowering therapy for type 2 diabetes, even before insulin treatment 3
- The choice of a specific GLP-1 receptor agonist depends on patient preferences, potential adverse effects, and cost 6
- Dual GIP/GLP-1 receptor agonists may be considered for patients with type 2 diabetes who do not have contraindications, but more research is needed to fully understand their clinical use 2