Effects of sequential treatment with lixisenatide, insulin glargine, or their combination on meal-related glycaemic excursions, insulin and glucagon secretion, and gastric emptying in patients with type 2 diabetes
| Autor: | Freimut Schliess, Juris J. Meier, Melanie Kahle-Stephan, Christoph Kapitza, Michael A. Nauck, BA Menge, Silke Erdmann, Nina Schenker |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Insulin Glargine 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology 03 medical and health sciences Lixisenatide chemistry.chemical_compound 0302 clinical medicine Endocrinology Internal medicine Internal Medicine medicine Humans Hypoglycemic Agents Insulin ddc:610 Meals Glucagon-like peptide 1 receptor Meal Gastric emptying business.industry Insulin glargine digestive oral and skin physiology Glucagon secretion medicine.disease Glucagon Postprandial Period chemistry Diabetes Mellitus Type 2 Gastric Emptying business Peptides medicine.drug |
| Popis: | \(\bf Aim:\) To examine the glucose-lowering mechanisms of the glucagon-like peptide-1 receptor agonist lixisenatide after two subsequent meals and in combination with basal insulin. \(\textbf {Materials and Methods:}\) Twenty-eight metformin-treated patients with type 2 diabetes were randomly assigned to treatment sequences with either lixisenatide or insulin glargine alone for 4 weeks, and a combination of both treatments for 4 weeks. Metabolic examinations were performed before and after each treatment period following breakfast and a late lunch 8 hours later. \(\bf Results:\) Lixisenatide mainly reduced postprandial glycaemia, while insulin glargine mainly reduced fasting glucose after breakfast (\(\it P\) < 0.05). This was partially preserved after a late lunch (\(\it P\) < 0.05). After breakfast, lixisenatide reduced insulin secretion and glucagon levels significantly. These effects were lost after a late lunch. Insulin glargine did not significantly reduce glucagon or insulin secretion. Gastric emptying was slowed by lixisenatide, but not by insulin glargine after breakfast. After the late lunch, lixisenatide slightly accelerated gastric emptying. \(\bf Conclusions:\) Lixisenatide decelerates gastric emptying after breakfast, thereby reducing glycaemic excursions, insulin secretion and glucagon levels. The glycaemic reduction persists until after a late lunch, despite accelerated gastric emptying. The combination with insulin glargine enhances the glucose-lowering effect because of complementary modes of action. |
| Databáze: | OpenAIRE |
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