title: Glucagon-like peptide 1 attenuates the acceleration of gastric emptying induced by hypoglycemia in healthy subjects.
abstract: OBJECTIVE
  Exogenous GLP-1 slows gastric emptying in health and diabetes leading to diminished glycemic excursions. Gastric emptying is markedly accelerated by hypoglycemia. The primary objective was to determine whether GLP-1 attenuates the acceleration of gastric emptying induced by hypoglycemia.
  
  
  METHODS
  Ten healthy volunteers were studied on four separate days in a randomized double-blind fashion. Blood glucose was stabilized using a glucose/insulin clamp at hypoglycemia (2.6 mmol/L on two occasions [hypo]) or euglycemia (6.0 mmol/L on two occasions [eu]) between T = -15 and 45 min before clamping at 6.0 mmol/L until 180 min. During hypoglycemia and euglycemia, subjects received intravenous GLP-1 (1.2 pmol/kg/min) or placebo. At T = 0 min, subjects ingested 100 g beef mince labeled with 20 MBq (99m)Tc-sulfur-colloid and 3 g of 3-O-methyl-glucose (3-OMG), a marker of glucose absorption. Gastric emptying was measured scintigraphically from T = 0 to 180 min and serum 3-OMG taken at 15-min intervals. The areas under the curve for gastric emptying and 3-OMG concentration were analyzed using one-way repeated-measures ANOVA with Bonferroni-Holm adjusted post hoc tests.
  
  
  RESULTS
  Gastric emptying was accelerated during hypoglycemia (hypo/placebo vs. eu/placebo; P < 0.001), as was glucose absorption (P < 0.03). GLP-1 slowed emptying during euglycemia (eu/placebo vs. eu/GLP-1; P < 0.001). However, hypoglycemia-induced acceleration of gastric emptying on placebo was markedly diminished by GLP-1 (hypo/placebo vs. hypo/GLP-1; P < 0.008), as was glucose absorption (P < 0.01).
  
  
  CONCLUSIONS
  Acute administration of exogenous GLP-1 attenuates, but does not abolish, the acceleration of gastric emptying by insulin-induced hypoglycemia in healthy subjects.
authors.affiliation: Discipline of Acute Care Medicine, University of Adelaide, Adelaide, AustraliaDepartment of Critical Care Services, Royal Adelaide Hospital, Adelaide, AustraliaCentre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia mark.philip.plummer@gmail.com.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Plummer
authors.affiliation: Centre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, AustraliaDiscipline of Medicine, University of Adelaide, Adelaide, Australia.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Jones
authors.affiliation: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Chris E
authors.initials: CE
authors.lastname: Annink
authors.affiliation: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Cousins
authors.affiliation: Diabetes Division, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Juris J
authors.initials: JJ
authors.lastname: Meier
authors.affiliation: Discipline of Acute Care Medicine, University of Adelaide, Adelaide, AustraliaDepartment of Critical Care Services, Royal Adelaide Hospital, Adelaide, AustraliaCentre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia.
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Chapman
authors.affiliation: Centre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, AustraliaDiscipline of Medicine, University of Adelaide, Adelaide, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
authors.affiliation: Discipline of Acute Care Medicine, University of Adelaide, Adelaide, AustraliaDepartment of Critical Care Services, Royal Adelaide Hospital, Adelaide, AustraliaCentre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Deane
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects* / Q000502:physiology; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage*; D015309:Glucose Clamp Technique; D064368:Healthy Volunteers; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000150:complications*; D007004:Hypoglycemic Agents / Q000009:adverse effects; D054795:Incretins / Q000008:administration & dosage*; D007275:Injections, Intravenous; D007328:Insulin / Q000009:adverse effects; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D052216:Glucagon-Like Peptide 1