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Cited by 261Diabetes Treatment and ManagementGastrointestinal motility and disordersDiabetes Management and Research

Effect of exenatide on gastric emptying and relationship to postprandial glycemia in type 2 diabetes

Linnebjerg, Helle, Park, Soomin, Kothare, Prajakti A., Trautmann, Michael E., Mace, Kenneth, Fineman, Mark, Wilding, Ian, Nauck, Michael +1 more·2008·Regulatory Peptides
DOI 10.1016/j.regpep.2008.07.003
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Abstract

Objectives To evaluate the effect of exenatide on gastric emptying (GE) in type 2 diabetes using scintigraphy. Methods Seventeen subjects with type 2 diabetes participated in a randomized, single-blind, 3-period, crossover study. In each 5-day period, 5 or 10 microg exenatide or placebo was administered subcutaneously BID. Oral antidiabetic treatments were continued. The presence of cardiac autonomic neuropathy was assessed during screening. On day 5, after the morning dose, subjects consumed a 450-kcal breakfast containing (99m)Tc-labeled eggs and (111)In-labeled water, and GE was measured by scintigraphy. Plasma glucose and insulin, perceptions of appetite, and plasma exenatide were also quantified. Results Exenatide slowed GE of both solid and liquid meal components [solid (T(50)(90% confidence interval [CI]); placebo, 60(50-70) min; 5 microg exenatide, 111(94-132) min; 10 microg exenatide, 169(143-201) min; both P<0.01); liquid (T(50)(90% CI), placebo, 34(25-46) min; 5 microg exenatide, 87(65-117) min; 10 microg exenatide, 114(85-154) min; both P<0.01)]. GE was not different between subjects with cardiac autonomic neuropathy (n=7), compared with those without (n=10) (P>/=0.68). Exenatide reduced postprandial glucose (area under the curve [AUC((0-6 h))]) by 69-76% and peak insulin (C(max)) by 84-86% compared with placebo. There was an inverse relationship between the postprandial rise in glucose (AUC((0-3 h))) and GE (solid T(50), r=-0.49, P<0.001). Conclusions Exenatide slows GE substantially in type 2 diabetes, which could be an important mechanism contributing to the beneficial effect of exenatide on postprandial glycemia.

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  • Nausea also occurs in the fasting state and is not related to measures of gastric emptying speed after meal ingestion.

    “However, nausea also occurs in the fasting state (44), and is not related to measures of gastric emptying speed after meal ingestion (45).”

    From Safety of Semaglutide (2021) · cites this paper as [44]

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Authors
Linnebjerg, H., Park, S., Kothare, P. A., Trautmann, M. E., Mace, K., Fineman, M., Wilding, I., Nauck, M., & Horowitz, M.
Affiliations
  • Eli Lilly (United States) (US)
  • Diabeteszentrum Bad Lauterberg (DE)
  • Royal Adelaide Hospital (AU)
Corresponding author
Linnebjerg, Helle
ORCID
Venue
Regulatory Peptides
Publisher
Elsevier BV
Published
2008-11
Volume
151
Issue
1-3
Pages
123-129
ISSN
0167-0115 (ISSN-L)
DOI
10.1016/j.regpep.2008.07.003
OpenAlex
W1984845045
Cited by
261
References
40
Citations by year
2026: 6 · 2025: 14 · 2024: 17 · 2023: 10 · 2022: 11 · 2021: 13 · 2020: 13 · 2019: 19 · 2018: 7 · 2017: 9 · 2016: 12 · 2015: 23 · 2014: 18 · 2013: 24 · 2012: 18
FWCI
11.37
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Regulatory Peptides (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders
  • Eli Lilly and Company
  • Amylin Pharmaceuticals
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
exenatide, gastric emptying, type 2 diabetes, postprandial blood glucose, GLP-1 receptor agonists, cardiac autonomic neuropathy, insulin response, appetite, meal timing, GLP-1 receptor antagonists
MeSH terms
Exenatide, Aged, Appetite, Blood Glucose, Diabetes Mellitus, Type 2, Drug Tolerance, Female, Gastric Emptying, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Peptides, Safety, Venoms, Single-Blind Method, Cross-Over Studies, Postprandial Period

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