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https://hdl.handle.net/2440/71522
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Type: | Journal article |
Title: | Effects of variations in duodenal glucose load on glycaemic, insulin, and incretin responses in type 2 diabetes |
Author: | Ma, J. Pilichiewicz, A. Feinle-Bisset, C. Wishart, J. Jones, K. Horowitz, M. Rayner, C. |
Citation: | Diabetic Medicine, 2012; 29(5):604-608 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2012 |
ISSN: | 0742-3071 1464-5491 |
Statement of Responsibility: | J. Ma, A. N. Pilichiewicz, C. Feinle-Bisset, J. M. Wishart, K. L. Jones, M. Horowitz and C. K. Rayner |
Abstract: | Aims: Postprandial glucagon-like peptide-1 (GLP-1) secretion and the 'incretin effect' have been reported to be deficient in Type 2 diabetes, but most studies have not controlled for variations in the rate of gastric emptying. We evaluated blood glucose, and plasma insulin, GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) responses to intraduodenal glucose in Type 2 diabetes, and compared these with data from healthy controls. Methods: Eight males with well-controlled Type 2 diabetes, managed by diet alone, were studied on four occasions in single-blind, randomized order. Blood glucose, and plasma insulin, GLP-1, and GIP were measured during 120-min intraduodenal glucose infusions at 1 kcal/min (G1), 2 kcal/min (G2) and 4 kcal/min (G4) or saline control. Results: Type 2 patients had higher basal (P < 0.0005) and incremental (P < 0.0005) blood glucose responses to G2 and G4, when compared with healthy controls. In both groups, the stimulation of insulin and GLP-1 by increasing glucose loads was not linear; responses to G1 and G2 were minimal, whereas responses to G4 were much greater (P < 0.005 for each) (incremental area under the GLP-1 curve 224 ± 65, 756 ± 331 and 2807 ± 473 pmol/l.min, respectively, in Type 2 patients and 373 ± 231, 505 ± 161 and 1742 ± 456 pmol/l.min, respectively, in healthy controls). The GLP-1 responses appeared comparable in the two groups. In both groups there was a load-dependent increase in plasma GIP with no difference between them. Conclusions: In patients with well-controlled Type 2 diabetes, blood glucose, insulin and GLP-1 responses are critically dependent on the small intestinal glucose load, and GLP-1 responses are not deficient. |
Keywords: | glucagon-like peptide 1 glucose-dependent insulinotropic polypeptide glycaemic control |
Rights: | © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK |
DOI: | 10.1111/j.1464-5491.2011.03496.x |
Published version: | http://dx.doi.org/10.1111/j.1464-5491.2011.03496.x |
Appears in Collections: | Aurora harvest Medicine publications |
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