# Effect of GLP-1 on microvascular insulin responses in type 1 diabetes

> **NIH NIH F32** · UNIVERSITY OF VIRGINIA · 2020 · $20,725

## Abstract

Project Summary/Abstract
Cardiovascular disease (CVD) is significantly increased in type 1 diabetes (T1DM) compared with the general
population. The CVD risk in T1DM is particularly exaggerated in women. Although thought of as an insulin
deficient state, T1DM also exhibits insulin resistance (IR), which may relate to supraphysiologic insulin
concentrations, hyperglycemia, endothelial dysfunction, and inflammation. In healthy humans, insulin causes
vasodilation at the microvascular level in skeletal and cardiac muscles to increase endothelial surface area
available for the delivery of nutrients, oxygen, and hormones such as insulin to these tissues. Using contrast
enhanced ultrasound (CEU) and insulin clamp, we have confirmed the presence of vascular and metabolic IR
in T1DM subjects. Women with T1DM may have greater IR compared with men with T1DM although this has
not previously been studied at the vascular level. IR independently predicts both microvascular complications
and macrovascular ones like CVD in T1DM. Thus far, there are no Federal Drug Administration approved
medications which target IR or vascular complications in T1DM. In large, randomized controlled clinical trials,
Glucagon-Like Peptide-1 (GLP-1) receptor agonists reduce major adverse cardiovascular events in type 2
diabetes. We have previously shown that GLP-1 infusion increases skeletal and cardiac microvascular
perfusion in healthy humans and restores insulin-mediated increase in skeletal and cardiac microvascular
perfusion in IR rodents. The impact of GLP-1 in T1DM vascular and systemic IR remains unknown. The herein
proposed research addresses the hypotheses that, in humans with T1DM, GLP-1 (a) increases microvascular
perfusion and improves insulin's microvascular response in skeletal muscle thereby enhancing insulin-
mediated glucose disposal and muscle oxygenation and (b) increases cardiac microvascular perfusion and
improves insulin's microvascular response in the heart and large vessel function. We will also test a sub-
hypothesis that women with T1DM have greater microvascular IR, but similar microvascular response to GLP-
1. We will utilize CEU to directly assess (1) the microvascular responses in skeletal and cardiac muscles to
insulin in men and women with T1DM, comparing the two genders, and (2) whether GLP-1 infusion improves
insulin-mediated skeletal and cardiac microvascular perfusion, large vessel compliance, and endothelial
dysfunction in T1DM. The proposed studies will fill a current gap in knowledge regarding microvascular IR and
tissue perfusion as well as vascular and systemic responses to GLP-1 in T1DM and the associated CVD risk
gender disparity. If our hypotheses are validated, it will introduce a potential treatment avenue for mitigating IR
and microvascular and macrovascular complications in T1DM.

## Key facts

- **NIH application ID:** 9980177
- **Project number:** 5F32DK121431-02
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Kaitlin M Love
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $20,725
- **Award type:** 5
- **Project period:** 2019-06-30 → 2020-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980177

## Citation

> US National Institutes of Health, RePORTER application 9980177, Effect of GLP-1 on microvascular insulin responses in type 1 diabetes (5F32DK121431-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9980177. Licensed CC0.

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