دورية أكاديمية
Mechanisms for the antihyperglycemic effect of sitagliptin in patients with type 2 diabetes.
| العنوان: | Mechanisms for the antihyperglycemic effect of sitagliptin in patients with type 2 diabetes. |
|---|---|
| المؤلفون: | E. Muscelli, A. Casolaro, A. Gastaldelli, A. Mari, G. Seghieri, B. Astiarraga, Y. Chen, M. Alba, J. Holst, FERRANNINI, ELEUTERIO |
| المساهمون: | E., Muscelli, A., Casolaro, A., Gastaldelli, A., Mari, G., Seghieri, B., Astiarraga, Y., Chen, M., Alba, J., Holst, Ferrannini, Eleuterio |
| سنة النشر: | 2012 |
| المجموعة: | ARPI - Archivio della Ricerca dell'Università di Pisa |
| مصطلحات موضوعية: | Adult, Aged, Blood Glucose, analysis, Diabetes Mellitu, Type 2, blood/drug therapy/physiopathology, Double-Blind Method, Female, Glucagon, blood, Glucagon-Like Peptide 1, Humans, Hypoglycemic Agent, pharmacology/therapeutic use, Insulin-Secreting Cell, drug effects/physiology, Male, Middle Aged, Pyrazine, Triazole |
| الوصف: | Dipeptidyl peptidase IV (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes. The underlying mechanisms (incretin effect, β-cell function, endogenous glucose production) are not well known.The aim of the study was to examine mechanisms of the antihyperglycemic effect of DPP-4 inhibitors.We administered a mixed meal with glucose tracers ([6,6-(2)H(2)]-glucose infused, [1-(2)H]-glucose ingested), and on a separate day, a glucose infusion matched the glucose responses to the meal (isoglycemic test) in 50 type 2 diabetes patients (hemoglobin A(1c) = 7.4 ± 0.8\%) and seven controls; 47 diabetic completers were restudied after 6 wk. Glucose fluxes were calculated, and β-cell function was assessed by mathematical modeling. The incretin effect was calculated as the ratio of oral to iv insulin secretion.We conducted a 6-wk, double-blind, randomized treatment with sitagliptin (100 mg/d; n = 25) or placebo (n = 22).Relative to placebo, meal-induced changes in fasting glucose and glucose area under the curve (AUC) were greater with sitagliptin, in parallel with a lower appearance of oral glucose [difference (post-pre) AUC = -353 ± 915 vs. +146 ± 601 μmol · kg(-1) · 5 h] and greater suppression of endogenous glucose production. Insulin sensitivity improved 10\%, whereas total insulin secretion was unchanged. During the meal, β-cell glucose sensitivity improved (+19[29] vs. 5[21] pmol · min(-1) · m(-2) · mm(-1); median [interquartile range]) and glucagon AUC decreased (19.6 ± 7.5 to 17.3 ± 7.1 ng · ml(-1) · 5 h), whereas intact glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 AUC increased with sitagliptin vs. placebo. The incretin effect was unchanged because sitagliptin increased β-cell glucose sensitivity also during the isoglycemic test.Chronic sitagliptin treatment improves glycemic control by lowering the appearance of oral glucose, postprandial endogenous glucose release, and glucagon response, and by improving insulin sensitivity and β-cell glucose sensing in response to ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/22685234; volume:97; firstpage:2818; lastpage:2826; numberofpages:8; journal:THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM; http://hdl.handle.net/11568/231754Test; http://dx.doi.org/10.1210/jc.2012-1205Test |
| DOI: | 10.1210/jc.2012-1205 |
| الإتاحة: | https://doi.org/10.1210/jc.2012-1205Test http://hdl.handle.net/11568/231754Test |
| رقم الانضمام: | edsbas.EA876C72 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1210/jc.2012-1205 |
|---|