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Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk diabetologi och metabolism.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk diabetologi och metabolism.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk diabetologi och metabolism.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Molekylär epidemiologi.
Vise andre og tillknytning
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 LTD , 2019. Vol. 181, nr 2, s. 161-171
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-390513DOI: 10.1530/EJE-19-0171ISI: 000472835100013PubMedID: 31176298OAI: oai:DiVA.org:uu-390513DiVA, id: diva2:1341845
Forskningsfinansiär
Swedish Diabetes AssociationErnfors FoundationEXODIAB - Excellence of Diabetes Research in SwedenTilgjengelig fra: 2019-08-12 Laget: 2019-08-12 Sist oppdatert: 2019-08-12bibliografisk kontrollert

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Almby, Kristina E.Abrahamsson, NiclasLundqvist, Martin H.Hammar, UlfThombare, KetanKarlsson, AndersSundbom, MagnusEriksson, Jan
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