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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Vella, A; Bock, G; Giesler, PD; Burton, DB; Serra, DB; Saylan, ML; Dunning, BE; Foley, JE; Rizza, RA; Camilleri, M.
Effects of dipeptidyl peptidase-4 inhibition on gastrointestinal function, meal appearance, and glucose metabolism in type 2 diabetes.
Diabetes. 2007; 56(5):1475-1480 Doi: 10.2337/db07-0136 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz: Treiber Gerlies
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Abstract:: OBJECTIVE: We sought to determine whether alterations in meal absorption and gastric emptying contribute to the mechanism by which inhibitors of dipeptidyl peptidase-4 (DPP-4) lower postprandial glucose concentrations. RESEARCH DESIGN AND METHODS: We simultaneously measured gastric emptying, meal appearance, endogenous glucose production, and glucose disappearance in 14 subjects with type 2 diabetes treated with either vildaglipitin (50 mg b.i.d.) or placebo for 10 days using a double-blind, placebo-controlled, randomized, crossover design. RESULTS: Fasting (7.3 +/- 0.5 vs. 7.9 +/- 0.5 mmol/l) and peak postprandial (14.1 +/- 0.6 vs. 15.9 +/- 0.9 mmol/l) glucose concentrations were lower (P < 0.01) after vildagliptin treatment than placebo. Despite lower glucose concentrations, postprandial insulin and C-peptide concentrations did not differ during the two treatments. On the other hand, the integrated (area under the curve) postprandial glucagon concentrations were lower (20.9 +/- 1.6 vs. 23.7 +/- 1.3 mg/ml per 5 h, P < 0.05), and glucagon-like peptide 1 (GLP-1) concentrations were higher (1,878 +/- 270 vs. 1,277 +/- 312 pmol/l per 5 h, P = 0.001) during vildagliptin administration compared with placebo. Gastric emptying and meal appearance did not differ between treatments. CONCLUSIONS: Vildagliptin does not alter gastric emptying or the rate of entry of ingested glucose into the systemic circulation in humans. DPP-4 inhibitors do not lower postprandial glucose concentrations by altering the rate of nutrient absorption or delivery to systemic circulation. Alterations in islet function, secondary to increased circulating concentrations of active GLP-1, are associated with the decreased postprandial glycemic excursion observed in the presence of vildagliptin.
Find related publications in this database (using NLM MeSH Indexing): Adenosine Deaminase - antagonists and inhibitors; Antigens, CD26 - antagonists and inhibitors; Appetite - antagonists and inhibitors; Blood Glucose - metabolism; Cross-Over Studies - metabolism; Diabetes Mellitus, Type 2 - blood; Double-Blind Method - blood; Eating - blood; Fasting - blood; Gastric Emptying - blood; Gastrointestinal Tract - physiopathology; Glucagon-Like Peptide 1 - blood; Glycoproteins - antagonists and inhibitors; Humans - antagonists and inhibitors; Postprandial Period - antagonists and inhibitors