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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(s) -
Alsalim Wathik,
Göransson Olga,
Tura Andrea,
Pacini Giovanni,
Mari Andrea,
Ahrén Bo
Publication year - 2020
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.13934
Subject(s) - incretin , medicine , endocrinology , metformin , sitagliptin , postprandial , type 2 diabetes , glucagon like peptide 1 , hormone , insulin , glucagon , vildagliptin , gastric inhibitory polypeptide , crossover study , dipeptidyl peptidase 4 , ingestion , placebo , diabetes mellitus , alternative medicine , pathology
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/m 2 , 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.