α‐Glucosidase inhibition (acarbose) fails to enhance secretion of glucagon‐like peptide 1 (7–36 amide) and to delay gastric emptying in Type 2 diabetic patients
Abstract
Aim Acarbose is able to enhance GLP-1 release and delay gastric emptying in normal subjects. The effect of alpha-glucosidase inhibition on GLP-1 has been less evident in Type 2 diabetic patients. The aim of this study was to investigate the possible influence of acarbose on GLP-1 release and gastric emptying in Type 2 diabetic patients after a mixed test meal. Patients and methods Ten Type 2 diabetic patients were tested with 100 mg acarbose or placebo served with a mixed meal that was labelled with 100 mg 13C-octanoic acid. Plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP-1 and GIP were determined over 6 h. Gastric emptying was measured by determining breath 13CO2 using infrared absorptiometry. Statistics repeated-measures anova. Results Gastric emptying rates (t1/2: 162 +/- 45 vs. 163 +/- 62 min, P = 0.65) and plasma concentrations (increasing from approximately 12 to approximately 25 pmol/l, P = 0.37) and integrated responses of GLP-1 (P = 0.37) were not changed significantly by acarbose treatment. Postprandial plasma glucose concentrations (P Conclusions In hyperglycaemic Type 2 diabetic patients, ingestion of acarbose with a mixed test meal failed to enhance GLP-1 release and did not influence gastric emptying.
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Patients with normal gastric anatomy may experience postprandial reactive hypoglycemia, early satiety and diarrhea due to primary accelerated gastric emptying.
“Patients with normal gastric anatomy may experience symptoms and signs, such as postprandial reactive hypoglycemia, early satiety and diarrhea, due to primary accelerated gastric emptying.[34, 35]”
From Postprandial Reactive Hypoglycemia (2019) · cites this paper as [34]
Cites
Plasma Insulin Responses to Oral and Intravenous Glucose: Studies in Normal and Diabetic Subjects*
Perley, M. J., & Kipnis, D. M. (1967) · Journal of Clinical Investigation · doi:10.1172/jci105685 · Cited by 917 · see citing works
Truncated GLP-1 (proglucagon 78?107-amide) inhibits gastric and pancreatic functions in man
Wettergren, A., Schjoldager, B., Mortensen, P. E., Myhre, J., Christiansen, J., & Holst, J. J. (1993) · Digestive Diseases and Sciences · doi:10.1007/bf01316798 · Cited by 670 · see citing works
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Jalleh, R. J., Jones, K. L., Rayner, C. K., Marathe, C. S., Wu, T., & Horowitz, M. (2022) · Diabetologia · doi:10.1007/s00125-022-05796-1 · Cited by 87 · see citing works
Postprandial Reactive Hypoglycemia
Altuntaş, Y. (2019) · SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital · doi:10.14744/semb.2019.59455 · Cited by 47 · see citing works
Ueno, H., Tsuchimochi, W., Wang, H.-W., Yamashita, E., Tsubouchi, C., Nagamine, K., Sakoda, H., & Nakazato, M. (2015) · Diabetes Therapy · doi:10.1007/s13300-015-0113-3 · Cited by 38 · see citing works
The role of GLP-1 in the postprandial effects of acarbose in type 2 diabetes
Dalsgaard, N. B., Gasbjerg, L. S., Hansen, L. S., Hansen, N. L., Stensen, S., Hartmann, B., Rehfeld, J. F., Holst, J. J., Vilsbøll, T., & Knop, F. K. (2021) · European Journal of Endocrinology · doi:10.1530/eje-20-1121 · Cited by 37 · see citing works
Self-citationYang, H. K., Lee, S.-H., Shin, J., Choi, Y.-H., Ahn, Y.-B., Lee, B.-W., Rhee, E. J., Min, K. W., & Yoon, K.-H. (2019) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2018.0054 · Cited by 25 · see citing works
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Chen, Z., Fu, X., Kuang, J., Chen, J., Chen, H., Pei, J., & Yang, H. (2016) · BMC Endocrine Disorders · doi:10.1186/s12902-016-0133-7 · Cited by 7 · see citing works
- Authors
- Hücking, K., Kostic, Z., Pox, C., Ritzel, R., Holst, J. J., Schmiegel, W., & Nauck, M. A.
- Affiliations
- Heidelberg University (DE)
- Universitätsklinikum Knappschaftskrankenhaus Bochum (DE)
- University of Copenhagen (DK)
- Corresponding author
- Nauck, M. A.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2005-03-21
- Volume
- 22
- Issue
- 4
- Pages
- 470-476
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2047352716
- Cited by
- 57
- References
- 2
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 6 · 2012: 4
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Bayer Vital
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- acarbose, alpha-glucosidase inhibitors, glucagon-like peptide-1, gastric emptying, type 2 diabetes, postprandial blood glucose, insulin secretion, C-peptide, glucagon, glucose-dependent insulinotropic polypeptide, incretins, mixed meal, hyperglycemia
- MeSH terms
- Blood Glucose, C-Peptide, Diabetes Mellitus, Type 2, Enzyme Inhibitors, Female, Gastric Emptying, Gastric Inhibitory Polypeptide, Glucagon, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Peptide Fragments, Protein Precursors, Postprandial Period, Acarbose, Glucagon-Like Peptide 1, Glycoside Hydrolase Inhibitors
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