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Metformin reduces the rate of small intestinal glucose absorption in type 2 diabetes
Author(s) -
Wu Tongzhi,
Xie Cong,
Wu Hang,
Jones Karen L.,
Horowitz Michael,
Rayner Christopher K.
Publication year - 2017
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12812
Subject(s) - metformin , postprandial , medicine , type 2 diabetes , crossover study , endocrinology , placebo , glucagon like peptide 1 , diabetes mellitus , alternative medicine , pathology
In rodents, metformin slows intestinal glucose absorption, potentially increasing exposure of the distal gut to glucose to enhance postprandial glucagon‐like peptide‐1 ( GLP ‐1) secretion. We evaluated the effects of metformin on serum 3‐O‐methylglucose (3‐ OMG ; a marker of glucose absorption) and plasma total GLP ‐1 concentrations during a standardized intraduodenal infusion of glucose and 3‐ OMG in patients with type 2 diabetes. A total of 12 patients, treated with metformin 850 mg twice daily or placebo for 7 days each in a double‐blind, randomized, crossover design (14 days’ washout between treatments), were evaluated on days 5 or 8 of each treatment (6 subjects each). On each study day, 30 minutes after ingesting 850 mg metformin or placebo, patients received an infusion of glucose (60 g + 5 g 3‐ OMG , dissolved in water to 240 mL ) via an intraduodenal catheter over the course of 120 minutes. Compared with placebo, metformin was associated with lower serum 3‐ OMG ( P < .001) and higher plasma total GLP ‐1 ( P = .003) concentrations. The increment in plasma GLP ‐1 after metformin vs placebo was related to the reduction in serum 3‐ OMG concentrations ( P = .019). Accordingly, metformin inhibits small intestinal glucose absorption, which may contribute to augmented GLP ‐1 secretion in type 2 diabetes.