Diabetes Mellitus Clinical Trial
Official title:
Effects of Sitagliptin on Postprandial Glycaemia, Incretin Hormones and Blood Pressure in Type 2 Diabetes - Relationship to Gastric Emptying
The purpose of this study is to evaluate the acute effects of sitagliptin on postprandial glycemia, incretin hormones and blood pressure, and the relationship to gastric emptying, after a mashed potato meal in patients with type 2 diabetes.
The purpose of this study is to (i) evaluate the acute effects of the dipeptidyl peptidase-4
(DPP-4) inhibitor, sitagliptin (100mg once daily for two days), on gastric emptying,
postprandial plasma glucose, insulin, glucagon and 'incretin' hormones (ie. glucagon-like
peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)), blood pressure and
heart rate after a high carbohydrate meal, and (ii) to determine whether the magnitude of the
effects of sitagliptin on postprandial glycaemia and blood pressure is related to the rate of
gastric emptying, in patients with type 2 diabetes.
The rate of entry of carbohydrate into the small intestine is especially important in
patients with diabetes mellitus. Sitagliptin is an orally administered inhibitor of
dipeptidyl-peptidase-IV (DPP-IV), the enzyme responsible for the degradation of GLP-1. It is
hypothesized that sitagliptin will increase the GLP-1 response to, and thereby slow gastric
emptying and diminish the glycaemic and blood pressure response to, a carbohydrate-containing
meal.
Twenty healthy subjects (male and female) will be studied. Each subject will be studied on
two occasions following treatment for 2 days with sitagliptin (100mg once daily) or matching
placebo in a randomized, double blind, crossover design. Measurements of gastric emptying,
intragastric meal distribution, blood glucose concentrations, gut hormones, blood pressure,
splanchnic flow and appetite will be measured for 4 hours following ingestion of a mashed
potato meal.
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