Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Abstract

AIMS:To determine the effects of the dipeptidyl peptidase-4 inhibitor, sitagliptin, on gastric emptying of a high carbohydrate meal and associated glycaemic and blood pressure responses in type 2 diabetes mellitus. MATERIALS AND METHODS:Fourteen patients with type 2 diabetes (9 male, 5 female; age: 67.8±1.5 years; BMI: 31.2±0.9 kg/m2 ; diabetes duration: 4.2±0.9 years; HbA1 c: 46±1.8 mmol/mol (6.4±0.2%), managed by diet and/or metformin, underwent concurrent measurements of gastric emptying, blood pressure and plasma glucose for 240 min after ingestion of a radiolabelled a mashed potato meal after receiving sitagliptin (100 mg) or placebo in randomised, double-blind, crossover fashion on two consecutive days. RESULTS:Sitagliptin reduced postprandial plasma glucose (P<0.005), without affecting gastric emptying (P=0.88). The magnitude of the glucose-lowering effect (change in iAUC0-240 min from placebo to sitagliptin) was related to gastric emptying (kcal/min) on placebo (r=0.68, P=0.008) There was a comparable fall in systolic blood pressure (P=0.80) following the meal without any difference between the two days. CONCLUSIONS:In type 2 diabetes, while sitagliptin has no effect on either gastric emptying or postprandial blood pressure, it's effects to lower postprandial glucose is dependent on the basal rate of gastric emptying. This article is protected by copyright. All rights reserved.