Study designĪll participants were studied on five occasions. The mean hemoglobin A 1c was 6.8 ± 1.3% (normal range, 4.8–6.0%), the total cholesterol concentration was 5.1 ± 1.06 mmol/liter (normal range, 0–5.2 mg/dl), the triglyceride concentration was 1.38 ± 0.44 mmol/liter (normal range, 0–2.3 mg/dl), and the fasting glucose concentration was 8.88 ± 2.72 mmol/liter (normal fasting range, 1.5 mg/dl) were excluded. Ten patients were treated with diet alone, one person received sulfonylurea (glibenclamide), and one was treated with metformin. The mean age was 57 ± 9 yr (mean ± sd), the body mass index was 30.2 ± 5.0 kg/m 2, the waist to hip ratio was 0.95 ± 0.11, and the diabetes duration was 4 ± 1 yr. Twelve patients with type 2 diabetes (five men and seven women) participated in the study.

Written informed consent was obtained from all participants. The study protocol was approved by the ethics committee of the Ruhr University of Bochum before the study. Preliminary results have been communicated in abstract form ( 23).

min) and placebo on glucose homeostasis in the fasting state as well as in the postprandial state and to quantify its effects on gastric emptying after a solid meal in patients with type 2 diabetes.

Therefore, it was the aim of this study to compare the effects of different infusion rates of GLP-1 (0.4, 0.8, and 1.2 pmol/kg There are only a few studies that compared smaller doses of GLP-1 ( 15, 22), but the relationship between the glucose-lowering effects and the deceleration of gastric emptying with different GLP-1 doses has not yet been studied in patients with type 2 diabetes.

In most previous studies using iv administration of GLP-1 in patients with type 2 diabetes, an infusion rate of 1.2 pmol/kg body weight Considering that disturbed gastrointestinal motility is present in at least a subgroup of patients with type 2 diabetes ( 19), one might speculate that further inhibition of gastric emptying by GLP-1 might not be beneficial in such patients. However, a deceleration of gastric motility may potentially lead to nausea or vomiting after meal ingestion ( 18). In addition to its metabolic effects, GLP-1 strongly decelerates gastric emptying ( 13– 16), thereby slowing the entry of nutrients into the circulation and reducing appetite and food intake ( 5, 17). metabolic disturbances after an acute myocardial infarction or major surgical procedures, the iv administration of native GLP-1 may be a suitable approach for glucose control ( 11, 12). A complete normalization of glucose concentrations, however, has only been demonstrated with the iv infusion of GLP-1 ( 1, 9, 10). Various attempts are currently being evaluated to make use of the antidiabetogenic properties of GLP-1 ( 6– 8). Due to the dose-dependent inhibition of gastric emptying, lower GLP-1 doses than previously used may be as suitable for glucose control in patients with type 2 diabetes.ĭUE TO ITS glucose-depending insulinotropic and glucagonostatic effects, the gut hormone glucagon-like peptide 1 (GLP-1) has promising potential for the treatment of type 2 diabetes ( 1– 5). Gastric emptying was decelerated by GLP-1 in a dose-dependent fashion ( P < 0.001).ĭespite a dose-dependent stimulation of insulin secretion, glucose normalization can be achieved even with 0.4 pmol GLP-1/kg Glucagon secretion was suppressed with GLP-1. Insulin and C-peptide concentrations dose-dependently rose during GLP-1 infusion in the fasting state ( P < 0.05), but were dose-dependently reduced by GLP-1 after meal ingestion ( P = 0.0031 and 0.0074, respectively). Plasma glucose concentrations were equally normalized with all GLP-1 doses ( P < 0.001). Statistics were determined using repeated measures ANOVA and Duncan’s post hoc test. The gastric emptying rate was calculated from the 13CO 2 excretion rates in breath samples. Blood was drawn for glucose, insulin, C-peptide, glucagon, and GLP-1 determinations. min) or placebo in the fasting state and after a solid test meal (containing octanoic acid).Twelve patients with type 2 diabetes received three different infusion rates of GLP-1 (0.4, 0.8, and 1.2 pmol/kg The effects of different iv doses of glucagon-like peptide 1 (GLP-1) on glucose homeostasis and gastric emptying were compared in patients with type 2 diabetes.

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