Small intestinal glucose delivery affects the glucose-lowering effect of acute vildagliptin in type 2 diabetes
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Small intestinal glucose delivery affects the glucose-lowering effect of acute vildagliptin in type 2 diabetes. / Wu, T; Zhang, X; Trahair, LG; Bound, MJ; Little, TL; Deacon, Carolyn F.; Horowitz, M; Jones, KL; Rayner, CK.
In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 12, 2016, p. 4769-4778.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Small intestinal glucose delivery affects the glucose-lowering effect of acute vildagliptin in type 2 diabetes
AU - Wu, T
AU - Zhang, X
AU - Trahair, LG
AU - Bound, MJ
AU - Little, TL
AU - Deacon, Carolyn F.
AU - Horowitz, M
AU - Jones, KL
AU - Rayner, CK
PY - 2016
Y1 - 2016
N2 - Context: The rate of gastric emptying is an important determinant of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) secretion and may influence the magnitude of glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors. Objective: To evaluate the effects of the DPP-4 inhibitor, vildagliptin (VILD), during intraduodenal (ID) glucose infusion at 2 different rates within the physiological range of gastric emptying, in type2 diabetes. Participants and Design: A total of 16 diet-controlled type 2 diabetic patients were studied on 4 separate days in double-blind, randomized, fashion. On each day, either 5-mg VILD or placebo (PLBO) was given 60 minutes before a 120-minute ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4). Plasma glucose and hormones were measured frequently. Results: Plasma glucose, insulin, C-peptide, glucagon, total GIP, and total and intact GLP-1 concentrationswere higher during ID4 than ID2 (P .01 for each). Compared with PLBO, VILD wasassociated with higher intact GLP-1, insulin, and C-peptide and lower glucose and total GIP and GLP-1 (P .01 for each), without affecting glucagon. There were significant interactions between the rate of ID glucose and VILD treatment on plasma glucose, intact and total GLP-1, and GIP (P.05 for each) but not insulin, C-peptide, or glucagon. The reduction in glucose and the increment in intactGLP-1 after VILD vs PLBO were 3.3- and 3.8-fold greater, respectively, during ID4 compared with ID2. Conclusions/Interpretation: These observations warrant further study to clarify whether type 2 diabetic patients with relatively more rapid gastric emptying have greater glucose lowering during treatment with DPP-4 inhibitors.
AB - Context: The rate of gastric emptying is an important determinant of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) secretion and may influence the magnitude of glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors. Objective: To evaluate the effects of the DPP-4 inhibitor, vildagliptin (VILD), during intraduodenal (ID) glucose infusion at 2 different rates within the physiological range of gastric emptying, in type2 diabetes. Participants and Design: A total of 16 diet-controlled type 2 diabetic patients were studied on 4 separate days in double-blind, randomized, fashion. On each day, either 5-mg VILD or placebo (PLBO) was given 60 minutes before a 120-minute ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4). Plasma glucose and hormones were measured frequently. Results: Plasma glucose, insulin, C-peptide, glucagon, total GIP, and total and intact GLP-1 concentrationswere higher during ID4 than ID2 (P .01 for each). Compared with PLBO, VILD wasassociated with higher intact GLP-1, insulin, and C-peptide and lower glucose and total GIP and GLP-1 (P .01 for each), without affecting glucagon. There were significant interactions between the rate of ID glucose and VILD treatment on plasma glucose, intact and total GLP-1, and GIP (P.05 for each) but not insulin, C-peptide, or glucagon. The reduction in glucose and the increment in intactGLP-1 after VILD vs PLBO were 3.3- and 3.8-fold greater, respectively, during ID4 compared with ID2. Conclusions/Interpretation: These observations warrant further study to clarify whether type 2 diabetic patients with relatively more rapid gastric emptying have greater glucose lowering during treatment with DPP-4 inhibitors.
U2 - 10.1210/jc.2016-2813
DO - 10.1210/jc.2016-2813
M3 - Journal article
C2 - 27598511
VL - 101
SP - 4769
EP - 4778
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 12
ER -
ID: 169969275