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Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
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2019 (engelsk)Inngår i: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 181, nr 2, s. 161-171Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

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.

sted, utgiver, år, opplag, sider
Bioscientifica, 2019. Vol. 181, nr 2, s. 161-171
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-161569DOI: 10.1530/EJE-19-0171ISI: 000472835100013PubMedID: 31176298OAI: oai:DiVA.org:umu-161569DiVA, id: diva2:1339023
Forskningsfinansiär
Swedish Diabetes AssociationTilgjengelig fra: 2019-07-25 Laget: 2019-07-25 Sist oppdatert: 2019-07-25bibliografisk kontrollert

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