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Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes.
Diabetologia. 2015 Aug; 58(8):1769-78.D

Abstract

AIMS/HYPOTHESIS

A postprandial fall in BP occurs frequently in older individuals and in patients with type 2 diabetes. The magnitude of this decrease in BP is related to the rate of gastric emptying (GE). Intravenous administration of glucagon-like peptide-1 (GLP-1) attenuates the hypotensive response to intraduodenal glucose in healthy older individuals. We sought to determine the effects of exogenous GLP-1 on BP, GE, superior mesenteric artery (SMA) flow and glycaemic response to oral ingestion of glucose in healthy older individuals and patients with type 2 diabetes.

METHODS

Fourteen older volunteers (six men, eight women; age 72.1 ± 1.1 years) and ten patients with type 2 diabetes (six men, four women; age 68.7 ± 3.4 years; HbA1c 6.6 ± 0.2% [48.5 ± 2.0 mmol/mol]; nine with blood glucose managed with metformin, two with a sulfonylurea and one with a dipeptidyl-peptidase 4 inhibitor) received an i.v. infusion of GLP-1 (0.9 pmol kg(-1) min(-1)) or saline (154 mmol/l NaCl) for 150 min (t = -30 min to t = 120 min) in randomised order. At t = 0 min, volunteers consumed a radiolabelled 75 g glucose drink. BP was assessed with an automated device, GE by scintigraphy and SMA flow by ultrasonography. Blood glucose and serum insulin were measured.

RESULTS

GLP-1 attenuated the fall in diastolic BP after the glucose drink in older individuals (p < 0.05) and attenuated the fall in systolic and diastolic BP in patients with type 2 diabetes (p < 0.05). GE was faster in patients with type 2 diabetes than in healthy individuals (p < 0.05). In both groups, individuals had slower GE (p < 0.001), decreased SMA flow (p < 0.05) and a lower degree of glycaemia (p < 0.001) when receiving GLP-1.

CONCLUSIONS/INTERPRETATION

Intravenous GLP-1 attenuates the hypotensive response to orally administered glucose and decreases SMA flow, probably by slowing GE. GLP-1 and 'short-acting' GLP-1 agonists may be useful in the management of postprandial hypotension.

Authors+Show Affiliations

Discipline of Medicine, The University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26048234

Citation

Trahair, Laurence G., et al. "Effects of Exogenous Glucagon-like Peptide-1 On Blood Pressure, Heart Rate, Gastric Emptying, Mesenteric Blood Flow and Glycaemic Responses to Oral Glucose in Older Individuals With Normal Glucose Tolerance or Type 2 Diabetes." Diabetologia, vol. 58, no. 8, 2015, pp. 1769-78.
Trahair LG, Horowitz M, Stevens JE, et al. Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes. Diabetologia. 2015;58(8):1769-78.
Trahair, L. G., Horowitz, M., Stevens, J. E., Feinle-Bisset, C., Standfield, S., Piscitelli, D., Rayner, C. K., Deane, A. M., & Jones, K. L. (2015). Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes. Diabetologia, 58(8), 1769-78. https://doi.org/10.1007/s00125-015-3638-0
Trahair LG, et al. Effects of Exogenous Glucagon-like Peptide-1 On Blood Pressure, Heart Rate, Gastric Emptying, Mesenteric Blood Flow and Glycaemic Responses to Oral Glucose in Older Individuals With Normal Glucose Tolerance or Type 2 Diabetes. Diabetologia. 2015;58(8):1769-78. PubMed PMID: 26048234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes. AU - Trahair,Laurence G, AU - Horowitz,Michael, AU - Stevens,Julie E, AU - Feinle-Bisset,Christine, AU - Standfield,Scott, AU - Piscitelli,Diana, AU - Rayner,Christopher K, AU - Deane,Adam M, AU - Jones,Karen L, Y1 - 2015/06/06/ PY - 2015/02/11/received PY - 2015/04/30/accepted PY - 2015/6/7/entrez PY - 2015/6/7/pubmed PY - 2016/4/14/medline SP - 1769 EP - 78 JF - Diabetologia JO - Diabetologia VL - 58 IS - 8 N2 - AIMS/HYPOTHESIS: A postprandial fall in BP occurs frequently in older individuals and in patients with type 2 diabetes. The magnitude of this decrease in BP is related to the rate of gastric emptying (GE). Intravenous administration of glucagon-like peptide-1 (GLP-1) attenuates the hypotensive response to intraduodenal glucose in healthy older individuals. We sought to determine the effects of exogenous GLP-1 on BP, GE, superior mesenteric artery (SMA) flow and glycaemic response to oral ingestion of glucose in healthy older individuals and patients with type 2 diabetes. METHODS: Fourteen older volunteers (six men, eight women; age 72.1 ± 1.1 years) and ten patients with type 2 diabetes (six men, four women; age 68.7 ± 3.4 years; HbA1c 6.6 ± 0.2% [48.5 ± 2.0 mmol/mol]; nine with blood glucose managed with metformin, two with a sulfonylurea and one with a dipeptidyl-peptidase 4 inhibitor) received an i.v. infusion of GLP-1 (0.9 pmol kg(-1) min(-1)) or saline (154 mmol/l NaCl) for 150 min (t = -30 min to t = 120 min) in randomised order. At t = 0 min, volunteers consumed a radiolabelled 75 g glucose drink. BP was assessed with an automated device, GE by scintigraphy and SMA flow by ultrasonography. Blood glucose and serum insulin were measured. RESULTS: GLP-1 attenuated the fall in diastolic BP after the glucose drink in older individuals (p < 0.05) and attenuated the fall in systolic and diastolic BP in patients with type 2 diabetes (p < 0.05). GE was faster in patients with type 2 diabetes than in healthy individuals (p < 0.05). In both groups, individuals had slower GE (p < 0.001), decreased SMA flow (p < 0.05) and a lower degree of glycaemia (p < 0.001) when receiving GLP-1. CONCLUSIONS/INTERPRETATION: Intravenous GLP-1 attenuates the hypotensive response to orally administered glucose and decreases SMA flow, probably by slowing GE. GLP-1 and 'short-acting' GLP-1 agonists may be useful in the management of postprandial hypotension. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/26048234/Effects_of_exogenous_glucagon_like_peptide_1_on_blood_pressure_heart_rate_gastric_emptying_mesenteric_blood_flow_and_glycaemic_responses_to_oral_glucose_in_older_individuals_with_normal_glucose_tolerance_or_type_2_diabetes_ L2 - https://doi.org/10.1007/s00125-015-3638-0 DB - PRIME DP - Unbound Medicine ER -