Glucagon is historically described as the counterregulatory hormone to insulin, induced by fasting/hypoglycemia to raise blood glucose through action mediated in the liver. However, it is becoming clear that the biology of glucagon is much more complex and extends beyond hepatic actions to exert control on glucose metabolism. We discuss the inconsistencies with the canonical view that glucagon is primarily a hyperglycemic agent driven by fasting/hypoglycemia and highlight the recent advances that have reshaped the metabolic role of glucagon. These concepts are placed within the context of both normal physiology and the pathophysiology of disease and then extended to discuss emerging strategies that incorporate glucagon agonism in the pharmacology of treating diabetes.

中文翻译：

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糖尿病生理学和药理学中胰高血糖素作用的重新定位

胰高血糖素历来被描述为胰岛素的反调节激素，由空腹/低血糖引起，通过肝脏介导的作用升高血糖。然而，越来越清楚的是，胰高血糖素的生物学要复杂得多，而且超出了肝脏的作用，可以控制葡萄糖代谢。我们讨论了与胰高血糖素主要是由空腹/低血糖驱动的高血糖药物的经典观点不一致的地方，并强调了重塑胰高血糖素代谢作用的最新进展。这些概念被置于正常生理学和疾病病理生理学的背景下，然后扩展到讨论将胰高血糖素激动剂纳入治疗糖尿病的药理学的新兴策略。