Improvement of postprandial endothelial function after a single dose of exenatide in individuals with impaired glucose tolerance and recent-onset type 2 diabetes.
OBJECTIVE
Endothelial dysfunction is frequently present in individuals with insulin resistance or type 2 diabetes and can be induced by high-fat or high-carbohydrate meals. Because exenatide reduces postprandial glucose and lipid excursions, we hypothesized that it may also improve postprandial endothelial function.


METHODS
In a double-blinded randomized crossover design, postprandial endothelial function was examined in 28 individuals with impaired glucose tolerance or recent-onset type 2 diabetes after a single injection of exenatide or placebo given just before a high-fat meal. Endothelial function was determined with peripheral arterial tonometry pre- and postprandially.


RESULTS
Postprandial endothelial function was higher after exenatide compared with placebo (P = 0.0002). In the placebo phase, postprandial change in endothelial function was inversely associated with mean postprandial concentrations of triglycerides (r = -0.62, P = 0.0004). Changes in postprandial triglyceride concentrations explained 64% of exenatide's effect on postprandial endothelial function.


CONCLUSIONS
Exenatide ameliorates postprandial endothelial dysfunction after a high-fat meal.
Koska
Juraj
J
Department of Endocrinology, Phoenix VA Health Care System, Phoenix, Arizona, USA. peter.reaven@med.va.gov
Schwartz
Eric A
EA
Mullin
Michael P
MP
Schwenke
Dawn C
DC
Reaven
Peter D
PD
D000328:Adult; D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage; D004727:Endothelium / Q000187:drug effects / Q000378:metabolism; D000077270:Exenatide; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood; D014688:Venoms / Q000008:administration & dosage*
D004041:Dietary Fats; D007004:Hypoglycemic Agents; D010455:Peptides; D014280:Triglycerides; D014688:Venoms; D000077270:Exenatide