The role of GLP-1 in the postprandial effects of acarbose in type 2 diabetes
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
The role of GLP-1 in the postprandial effects of acarbose in type 2 diabetes. / Dalsgaard, Niels B; Gasbjerg, Lærke S; Hansen, Laura S; Hansen, Nina L; Stensen, Signe; Hartmann, Bolette; Rehfeld, Jens F; Holst, Jens J; Vilsbøll, Tina; Knop, Filip K.
I: European Journal of Endocrinology, Bind 184, Nr. 3, 2021, s. 387-398.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - The role of GLP-1 in the postprandial effects of acarbose in type 2 diabetes
AU - Dalsgaard, Niels B
AU - Gasbjerg, Lærke S
AU - Hansen, Laura S
AU - Hansen, Nina L
AU - Stensen, Signe
AU - Hartmann, Bolette
AU - Rehfeld, Jens F
AU - Holst, Jens J
AU - Vilsbøll, Tina
AU - Knop, Filip K
PY - 2021
Y1 - 2021
N2 - Aims: The alpha-glucosidase inhibitor acarbose is believed to reduce plasma glucose by delaying hydrolysis of carbohydrates. Acarbose-induced transfer of carbohydrates to the distal parts of the intestine increases circulating glucagon-like peptide 1 (GLP-1). Using the GLP-1 receptor antagonist exendin(9-39)NH2, we investigated the effect of acarbose-induced GLP-1 secretion on postprandial glucose metabolism in patients with type 2 diabetes.Methods: In a double-blinded, placebo-controlled, randomized, crossover study, 15 participants with metformin-treated type 2 diabetes (age: 57-85 years, HbA1c: 40-74 mmol/mol) were subjected to two 14-day treatment periods with acarbose or placebo, respectively, separated by a 6-week wash-out period. At the end of each period, two randomized 4-h liquid mixed meal tests with concomitant infusion of exendin(9-39)NH2 and saline, respectively, were performed.Results: Compared to placebo, acarbose increased postprandial GLP-1 concentrations and decreased postprandial glucose. We observed no absolute difference in the exendin(9-39)NH2-induced increase in postprandial glucose excursions between placebo and acarbose periods, but relatively, postprandial glucose was increased by 119 ± 116% (mean ± s.d.) during exendin(9-39)NH2 infusion in the acarbose period vs a 39 ± 27% increase during the placebo period (P = 0.0163).Conclusions: We confirm that acarbose treatment stimulates postprandial GLP-1 secretion in patients with type 2 diabetes. Using exendin(9-39)NH2, we did not see an impact of acarbose-induced GLP-1 secretion on absolute measures of postprandial glucose tolerance, but relatively, the effect of exendin(9-39)NH2 was most pronounced during acarbose treatment.
AB - Aims: The alpha-glucosidase inhibitor acarbose is believed to reduce plasma glucose by delaying hydrolysis of carbohydrates. Acarbose-induced transfer of carbohydrates to the distal parts of the intestine increases circulating glucagon-like peptide 1 (GLP-1). Using the GLP-1 receptor antagonist exendin(9-39)NH2, we investigated the effect of acarbose-induced GLP-1 secretion on postprandial glucose metabolism in patients with type 2 diabetes.Methods: In a double-blinded, placebo-controlled, randomized, crossover study, 15 participants with metformin-treated type 2 diabetes (age: 57-85 years, HbA1c: 40-74 mmol/mol) were subjected to two 14-day treatment periods with acarbose or placebo, respectively, separated by a 6-week wash-out period. At the end of each period, two randomized 4-h liquid mixed meal tests with concomitant infusion of exendin(9-39)NH2 and saline, respectively, were performed.Results: Compared to placebo, acarbose increased postprandial GLP-1 concentrations and decreased postprandial glucose. We observed no absolute difference in the exendin(9-39)NH2-induced increase in postprandial glucose excursions between placebo and acarbose periods, but relatively, postprandial glucose was increased by 119 ± 116% (mean ± s.d.) during exendin(9-39)NH2 infusion in the acarbose period vs a 39 ± 27% increase during the placebo period (P = 0.0163).Conclusions: We confirm that acarbose treatment stimulates postprandial GLP-1 secretion in patients with type 2 diabetes. Using exendin(9-39)NH2, we did not see an impact of acarbose-induced GLP-1 secretion on absolute measures of postprandial glucose tolerance, but relatively, the effect of exendin(9-39)NH2 was most pronounced during acarbose treatment.
KW - Acarbose/pharmacology
KW - Aged
KW - Aged, 80 and over
KW - Blood Glucose/drug effects
KW - Cross-Over Studies
KW - Denmark
KW - Diabetes Mellitus, Type 2/drug therapy
KW - Double-Blind Method
KW - Female
KW - Gastric Emptying/drug effects
KW - Glucagon-Like Peptide 1/physiology
KW - Humans
KW - Insulin Resistance
KW - Insulin-Secreting Cells/drug effects
KW - Male
KW - Metformin/therapeutic use
KW - Middle Aged
KW - Placebos
KW - Postprandial Period/drug effects
U2 - 10.1530/EJE-20-1121
DO - 10.1530/EJE-20-1121
M3 - Journal article
C2 - 33449919
VL - 184
SP - 387
EP - 398
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
SN - 0804-4643
IS - 3
ER -
ID: 258268287