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The Cephalic Insulin Response to Meal Ingestion in Humans Is Dependent on Both Cholinergic and Noncholinergic Mechanisms and Is Important for Postprandial Glycemia
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We studied the mechanisms and physiological relevance of the cephalic insulin response to meal ingestion in 12 healthy women (age 63 ± 0.4 years; BMI 27.7 ± 1.7 kg/m2). The ganglionic antagonist, trimethaphan, which impairs neurotransmission across parasympathetic and sympathetic autonomic ganglia, or atropine or saline was given intravenously during the first 15 min after ingestion of a standard meal (350 kcal). During saline infusion, insulin levels increased during the first 10 min after meal ingestion, whereas the first increase in glucose was evident at 15 min. The preabsorptive 10-min insulin response was reduced by 73 ± 11% by trimethaphan (P = 0.009), accompanied by impaired reduction of glucose levels from 25 to 60 min after meal ingestion (Δglucose = –1.27 ± 0.5 [with saline] vs. 0.1 ± 0.4 mmol/l [with trimethaphan]; P = 0.008). This reduction at 25–60 min in glucose levels correlated significantly to the 10-min insulin response (r = 0.65, P = 0.024). The 10-min insulin response to meal ingestion was also reduced by atropine, but only by 20 ± 9% (P = 0.045), which was lower than the reduction with trimethaphan (P = 0.004). The preabsorptive insulin response was not accompanied by any increase in circulating levels of gastric inhibitory polypeptide (GIP) or glucagon-like peptide 1 (GLP-1). In conclusion, 1) the early preabsorptive insulin response to meal ingestion in humans can be largely attributed to autonomic activation mediated by noncholinergic and cholinergic mechanisms, 2) this cephalic insulin response is required for a normal postprandial glucose tolerance, and 3) GIP and GLP-1 do not contribute to the preabsorptive cephalic phase insulin response to meal ingestion.
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“The neural mechanism underlying cephalic phase insulin response was found to include cholinergic and non-cholinergic processes136 as well as the dorsal vagal complex located in the medulla oblongata.137”
From Pancreatic regulation of glucose homeostasis. (2016) · cites this paper as [136]
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“Moreover, cephalic phase insulin response is pivotal for ensuring normal postprandial glucose management.136”
From Pancreatic regulation of glucose homeostasis. (2016) · cites this paper as [136]
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“Particularly, a study by Ahren and Holst showed that the pre-absorptive insulin response to meal ingestion in humans was largely attributed to autonomic activation [27].”
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Metadata
- Authors
- Ahrén, B., & Holst, J. J.
- Affiliations
- Department of Medicine, Lund University, Lund, Sweden, and
- University of Copenhagen (DK)
- ORCID
- Holst, Jens J.
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2001-05-01
- Volume
- 50
- Issue
- 5
- Pages
- 1030-1038
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2168149788
- Cited by
- 292
- References
- 52
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 9 · 2021: 15 · 2020: 12 · 2019: 14 · 2018: 17 · 2017: 13 · 2016: 16 · 2015: 22 · 2014: 14 · 2013: 9 · 2012: 11
- FWCI
- 8.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- meal ingestion, postprandial blood glucose, cholinergic mechanisms, trimethaphan, atropine, autonomic nervous system, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, glucose tolerance
- MeSH terms
- Insulin Secretion, Blood Glucose, Blood Pressure, Eating, Female, Ganglionic Blockers, Gastric Inhibitory Polypeptide, Glucagon, Humans, Insulin, Middle Aged, Peptide Fragments, Protein Precursors, Reference Values, Time Factors, Trimethaphan, Body Mass Index, Postmenopause, Postprandial Period, Area Under Curve, Glucagon-Like Peptide 1
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