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- Title
Antidiabetogenic action of glucagon-like peptide-1 related to administration relative to meal intake in subjects with type 2 diabetes.
- Authors
Gutniak, M. K.; Svartberg, J.; Hellström, P. M.; Holst, J. J.; Adner, N.; Ahrén, B.; Hellström, P M; Ahrén, B
- Abstract
Gutniak MK, Svartberg J, Hellström PM, Holst JJ, Adner N, Ahrén B (Södersjukhuset, Stockholm, Sweden; University Hospital of Tromsö, Tromsö, Norge; Karolinska Hospital, Stockholm, Sweden; PANUM Institute, Copenhagen, Denmark; and Lund University, Lund, Sweden). Antidiabetogenic action of GLP-1 related to administration relative to meal intake in subjects with type 2 diabetes. J Intern Med 2001; 250: 81–87. Objective. To establish the antidiabetogenic effect of glucagon-like peptide-1 (GLP-1) when differently administered relative to meal intake in subjects with type 2 diabetes. Design. The study was a placebo-controlled comparison with random assignment to treatment sequence. A 3-h stepwise infusion of GLP-1 (17 nmol) was started either at the onset of a standard meal (550 kCal) (A) or at 30 min (B) or 60 min (C) after the start of the meal. Setting. The study was conducted at a university hospital. Subjects. Eight patients with type 2 diabetes (four women and four men), age 62 ± 3.9 years (range 47–74 years), weight 79.8 ± 5.4 kg (range 62–104 kg), BMI 26.2 ± 1.3 kg m–2 (range 21–31 kg m–2), diabetes duration 10.5 ± 2.0 years (range 3–19 years) and HbA1c levels 6.1 ± 0.3% (range 4.7–7.7%) participated in the study. All patients were treated with oral sulphonylureas. Results. Glucagon-like peptide-1 significantly lowered postprandial glycaemia by a similar degree in all three situations versus the control meal (P < 0.05). Postprandial insulin levels were not different in the four experimental series, whereas the postprandial glucagon levels were significantly lowered by GLP-1 in (A) and (B) (P < 0.03) but not in (C). Gastric emptying, as determined by the paracetamol test, was retarded by GLP-1 only in (A) (P < 0.01), but not affected in (B) or (C). Conclusions. GLP-1 reduced postprandial hyperglycaemia in subjects with type 2 diabetes regardless of administration at the onset of meal intake or at 30 or 60 min after start of meal intake, although the mechanism of the antidiabetogenic action of GLP-1 depended on administration versus meal intake. Thus, when administered at the start of a meal, GLP-1 was antidiabetogenic mainly through retarding gastric emptying, whereas when given at 30 or 60 min after meal ingestion, changes in islet hormone secretion seem to be predominant.
- Subjects
GLUCAGON-like peptide 1; TYPE 2 diabetes; TREATMENT of diabetes; PHYSIOLOGY
- Publication
Journal of Internal Medicine, 2001, Vol 250, Issue 1, p81
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1046/j.1365-2796.2001.00862.x