Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
| Autor: | Niclas Abrahamsson, F. Anders Karlsson, Magnus Sundbom, Ketan Thombare, Kristina E. Almby, Ulf Hammar, Amalia Panagiotou, Jan W. Eriksson, Martin Lundqvist, Urban Wiklund |
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| Rok vydání: | 2019 |
| Předmět: |
Agonist
Adult Blood Glucose Male medicine.medical_specialty Sympathetic Nervous System Hydrocortisone medicine.drug_class Endocrinology Diabetes and Metabolism Gastric Bypass Hypoglycemia medicine.disease_cause Glucagon Incretins Endocrinology Catecholamines Glucagon-Like Peptide 1 Heart Rate Parasympathetic Nervous System Internal medicine medicine Heart rate variability Humans Postoperative Period Cross-Over Studies business.industry Gastric bypass surgery Human Growth Hormone General Medicine Glucose clamp technique Middle Aged medicine.disease Glucose Clamp Technique Exenatide Female business Hormone medicine.drug |
| Zdroj: | European journal of endocrinology. 181(2) |
| ISSN: | 1479-683X |
| Popis: | Objectives The aim of the study was to explore the role of GLP-1 receptor activation on the counter-regulation and symptoms of hypoglycemia in subjects who have undergone gastric bypass surgery (GBP). Design Experimental hyperinsulinemic–hypoglycemic clamp study. Methods Twelve post-GBP subjects participated in a randomized cross-over study with two hyperinsulinemic, hypoglycemic clamps (glucose nadir 2.7 mmol/L) performed on separate days with concomitant infusions of the GLP-1 analog exenatide or with saline, respectively. Continuous measurements of metabolites and counter-regulatory hormones as well as assessments of heart rate variability and symptoms of hypoglycemia were performed throughout the clamps. Results No effect of GLP-1 receptor activation on counter-regulatory hormones (glucagon, catecholamines, cortisol, GH) or glucose infusion rate was seen, but we found indications of a downregulation of the sympathetic relative to the parasympathetic nerve activity, as reflected in heart rate variability. No significant differences in symptom of hypoglycemia were observed. Conclusions/interpretation Short-term exposure to a GLP-1 receptor agonist does not seem to impact the counter-regulatory hormonal and metabolic responses in post-GBP subjects during hypoglycemic conditions, suggesting that the improvement in symptomatic hypoglycemia post-GBP seen following treatment with GLP-1 receptor agonists may be mediated by mechanism not directly involved in counter-regulation. |
| Databáze: | OpenAIRE |
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