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GLP-1 is degraded extensively by the endothelial DPP-IV and consequently only 10-15% of secreted GLP-1 enters the systemic circulation in the active form ( In contrast to the high GLP-1 group, DPP-IV inhibition did not significantly alter plasma glucose, insulin levels, insulin resistance and beta cell function indices in the low GLP-1 prediabetes group

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However, because this excretion accounts for less than 1% of total acylcarnitine elimination in urine [43], it is unlikely that excretion of VPA alone is sufficient to produce carnitine deficiency in well nourished patients [44]

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