Gastric emptying, glucose responses, and insulin secretion after a liquid test meal: effects of exogenous glucagon-like peptide-1 (GLP-1)-(7-36) amide in type 2 (noninsulin-dependent) diabetic patients.
Abstract
The aim of the study was to investigate whether inhibition of gastric emptying of meals plays a role in the mechanism of the blood glucose-lowering action of glucagon-like peptide-1-(7-36) amide [GLP-1-(7-36) amide] in type 2 diabetes. Eight poorly controlled type 2 diabetic patients (age, 58 +/- 6 yr; body mass index, 30.0 +/- 5.2 kg/m2; hemoglobin A1c, 10.5 +/- 1.2%) were studied in the fasting state (plasma glucose, 11.1 +/- 1.1 mmol/L). A liquid meal of 400 mL containing 8% amino acids and 50 g sucrose (327 Kcal) was administered at time zero by a nasogastric tube. Gastric volume was determined by a dye dilution technique using phenol red. In randomized order, GLP-1-(7-36) amide (1.2 pmol/kg.min; Saxon Biochemicals) or placebo (0.9% NaCl with 1% human serum albumin) was infused between -30 and 240 min. In the control experiment, gastric emptying was completed within 120 min, and plasma glucose, insulin, C-peptide, GLP-1-(7-36) amide, and glucagon concentrations transiently increased. With exogenous GLP-1-(7-36) amide (plasma level, approximately 70 pmol/L), gastric volume remained constant over the period it was measured (120 min; P < 0.0001 vs. placebo), and plasma glucose fell to normal fasting values (5.4 +/- 0.7 mmol/L) within 3-4 h, whereas insulin was stimulated in most, but not all, patients, and glucagon remained at the basal level or was slightly suppressed. In conclusion, GLP-1-(7-36) amide inhibits gastric emptying in type 2 diabetic patients. Together with the…
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GLP-1 has extrapancreatic actions: suppression of endogenous glucose production/glycogenolysis, glucagon secretion, appetite, delay in gastric emptying, improved β-cell insulin sensitivity and glucose disposal; GIP positively affects lipid and bone metabolism.
“The extrapancreatic actions of GLP-1 include suppression of endogenous glucose production196/glycogenolysis,197 glucagon secretion,197, 198 appetite,199, 200 a delay in gastric emptying198, 199 and improved β-cell insulin sensitivity199, 201, 202 and glucose disposal,203, 204 whereas GIP positively affects lipid205, 206, 207 and bone metabolism.208, 209, 210, 211”
From Pancreatic regulation of glucose homeostasis. (2016) · cites this paper as [198]
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 [45]
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- Authors
- Willms, B., Werner, J., Holst, J. J., Orskov, C., Creutzfeldt, W., & Nauck, M. A.
- Affiliations
- Diabeteszentrum Bad Lauterberg (DE)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1996-01
- Volume
- 81
- Issue
- 1
- Pages
- 327-332
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1969759659
- Cited by
- 502
- References
- 3
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 23 · 2023: 16 · 2022: 12 · 2021: 15 · 2020: 12 · 2019: 13 · 2018: 14 · 2017: 18 · 2016: 23 · 2015: 19 · 2014: 18 · 2013: 18 · 2012: 17
- FWCI
- 12.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- 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
- glucagon-like peptide-1, GLP-1(7-36)amide, type 2 diabetes, gastric emptying, glycemic response, insulin secretion, glucagon secretion, C-peptide, blood glucose reduction, gastric volume, incretin-based therapy, glycemic control, uncontrolled diabetes, GLP-1 receptor
- MeSH terms
- Insulin Secretion, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Gastric Emptying, Glucagon, Humans, Insulin, Male, Middle Aged, Peptide Fragments, Protein Precursors, Glucagon-Like Peptide 1
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