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Glucagon-like peptide 1 attenuates the acceleration of gastric emptying induced by hypoglycemia in healthy subjects.

Author(s): Plummer MP(1), Jones KL(2), Annink CE(3), Cousins CE(3), Meier JJ(4), Chapman MJ(5), Horowitz M(2), Deane AM(5).

Affiliation(s): Author information: (1)Discipline of Acute Care Medicine, University of Adelaide, Adelaide, AustraliaDepartment of Critical Care Services, Royal Adelaide Hospital, Adelaide, AustraliaCentre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia mark.philip.plummer@gmail.com. (2)Centre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, AustraliaDiscipline of Medicine, University of Adelaide, Adelaide, Australia. (3)Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia. (4)Diabetes Division, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany. (5)Discipline of Acute Care Medicine, University of Adelaide, Adelaide, AustraliaDepartment of Critical Care Services, Royal Adelaide Hospital, Adelaide, AustraliaCentre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia.

Publication date & source: 2014, Diabetes Care. , 37(6):1509-15

OBJECTIVE: Exogenous GLP-1 slows gastric emptying in health and diabetes leading to diminished glycemic excursions. Gastric emptying is markedly accelerated by hypoglycemia. The primary objective was to determine whether GLP-1 attenuates the acceleration of gastric emptying induced by hypoglycemia. RESEARCH DESIGN AND METHODS: Ten healthy volunteers were studied on four separate days in a randomized double-blind fashion. Blood glucose was stabilized using a glucose/insulin clamp at hypoglycemia (2.6 mmol/L on two occasions [hypo]) or euglycemia (6.0 mmol/L on two occasions [eu]) between T = -15 and 45 min before clamping at 6.0 mmol/L until 180 min. During hypoglycemia and euglycemia, subjects received intravenous GLP-1 (1.2 pmol/kg/min) or placebo. At T = 0 min, subjects ingested 100 g beef mince labeled with 20 MBq (99m)Tc-sulfur-colloid and 3 g of 3-O-methyl-glucose (3-OMG), a marker of glucose absorption. Gastric emptying was measured scintigraphically from T = 0 to 180 min and serum 3-OMG taken at 15-min intervals. The areas under the curve for gastric emptying and 3-OMG concentration were analyzed using one-way repeated-measures ANOVA with Bonferroni-Holm adjusted post hoc tests. RESULTS: Gastric emptying was accelerated during hypoglycemia (hypo/placebo vs. eu/placebo; P < 0.001), as was glucose absorption (P < 0.03). GLP-1 slowed emptying during euglycemia (eu/placebo vs. eu/GLP-1; P < 0.001). However, hypoglycemia-induced acceleration of gastric emptying on placebo was markedly diminished by GLP-1 (hypo/placebo vs. hypo/GLP-1; P < 0.008), as was glucose absorption (P < 0.01). CONCLUSIONS: Acute administration of exogenous GLP-1 attenuates, but does not abolish, the acceleration of gastric emptying by insulin-induced hypoglycemia in healthy subjects.

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