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- Title
Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery.
- Authors
Almby, Kristina E.; Abrahamsson, Niclas; Lundqvist, Martin H.; Hammar, Ulf; Thombare, Ketan; Panagiotou, Amalia; Karlsson, F. Anders; Sundbom, Magnus; Wiklund, Urban; Eriksson, Jan W.
- Abstract
Objectives: The aim of the study was to explore the role of GLP-1 receptor activation on the counter-regulation and symptoms of hypoglycemia in subjects who have undergone gastric bypass surgery (GBP). Design: Experimental hyperinsulinemic–hypoglycemic clamp study. Methods: Twelve post-GBP subjects participated in a randomized cross-over study with two hyperinsulinemic, hypoglycemic clamps (glucose nadir 2.7 mmol/L) performed on separate days with concomitant infusions of the GLP-1 analog exenatide or with saline, respectively. Continuous measurements of metabolites and counter-regulatory hormones as well as assessments of heart rate variability and symptoms of hypoglycemia were performed throughout the clamps. Results: No effect of GLP-1 receptor activation on counter-regulatory hormones (glucagon, catecholamines, cortisol, GH) or glucose infusion rate was seen, but we found indications of a downregulation of the sympathetic relative to the parasympathetic nerve activity, as reflected in heart rate variability. No significant differences in symptom of hypoglycemia were observed. Conclusions/interpretation: Short-term exposure to a GLP-1 receptor agonist does not seem to impact the counterregulatory hormonal and metabolic responses in post-GBP subjects during hypoglycemic conditions, suggesting that the improvement in symptomatic hypoglycemia post-GBP seen following treatment with GLP-1 receptor agonists may be mediated by mechanism not directly involved in counter-regulation.
- Subjects
HEART beat; HYPOGLYCEMIA; GASTRIC bypass; GLUCOSE clamp technique; GLUCAGON-like peptide-1 agonists
- Publication
European Journal of Endocrinology, 2019, Vol 181, Issue 2, p161
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-19-0171