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Wathik Alsalim

Research project participant

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Persistent whole day meal effects of three dipeptidyl peptidase-4 inhibitors on glycaemia and hormonal responses in metformin-treated type 2 diabetes

Author

  • Wathik Alsalim
  • Olga Göransson
  • Andrea Tura
  • Giovanni Pacini
  • Andrea Mari
  • Bo Ahrén

Summary, in English

Aim: Dipeptidyl peptidase-4 (DPP-4) inhibition has effects on both fasting and postprandial glucose. However, the extent of this effect over the whole day and whether different DPP-4 inhibitors have the same effects have not been established. We therefore explored the whole day effects of three different DPP-4 inhibitors versus placebo on glucose, islet and incretin hormones after ingestion of breakfast, lunch and dinner in subjects with metformin-treated and well-controlled type 2 diabetes. Methods: The study was single-centre and crossover designed, involving 24 subjects [12 men, 12 women, mean age 63 years, body mass index 31.0 kg/m2, glycated haemoglobin 44.7 mmol/mol (6.2%)], who underwent four test days in random order. Each whole day test included ingestion of standardized breakfast (525 kcal), lunch (780 kcal) and dinner (560 kcal) after intake of sitagliptin (100 mg) or vildagliptin (50 mg twice), or saxagliptin (5 mg) or placebo. Results: Compared with placebo, DPP-4 inhibition reduced glucose levels, increased beta-cell function (insulin secretory rate in relation to glucose), suppressed glucagon, increased intact glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) but suppressed total GLP-1 and GIP after all three meals. The effects were sustained throughout the daytime period with similar changes after each meal and did not differ between the DPP-4 inhibitors. Conclusions: DPP-4 inhibition has persistent daytime effects on glucose, islet and incretin hormones with no difference between three different DPP-4 inhibitors.

Department/s

  • Diabetes
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • Protein Phosphorylation

Publishing year

2020-04

Language

English

Pages

590-598

Publication/Series

Diabetes, Obesity and Metabolism

Volume

22

Issue

4

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Endocrinology and Diabetes

Keywords

  • beta-cell function
  • DPP-4 inhibitor
  • incretin hormones
  • insulin secretion
  • saxagliptin
  • sitagliptin
  • type 2 diabetes
  • vildagliptin

Status

Published

Research group

  • Diabetes
  • Protein Phosphorylation

ISBN/ISSN/Other

  • ISSN: 1462-8902