Hjerpsted, JB, Flint, A, Brooks, A et al. (3 more authors) (2018) Semaglutide improves postprandial glucose and lipid metabolism, and delays first‐hour gastric emptying in subjects with obesity. Diabetes, Obesity and Metabolism, 20 (3). pp. 610-619. ISSN 1462-8902
Abstract
Aim: To investigate the effects of semaglutide on fasting and postprandial glucose and lipid responses, and on gastric emptying. Materials and Methods: This was a randomised, double-blind, placebo-controlled, two-period, crossover trial. Subjects with obesity (N = 30) received once-weekly subcutaneous semaglutide, dose-escalated to 1.0 mg, or placebo. After each 12-week treatment period, glucose and lipid metabolism were assessed before and after standardised meals. Gastric emptying (paracetamol absorption test) and peptide YY (PYY) response were also assessed. Results: Semaglutide treatment significantly lowered fasting concentrations of glucose and glucagon, and increased insulin versus placebo (estimated treatment ratio: 0.95 [95% confidence interval: 0.91, 0.98]; 0.86 [0.75, 0.98]; 1.45 [1.20, 1.75], respectively). Postprandial glucose metabolism significantly improved with semaglutide versus placebo (incremental area under the curve 0–5 hours [iAUC0-5h]; estimated treatment difference: glucose −1.34 mmol*h/L [−2.42, −0.27]; insulin −921 pmol*h/L [−1461, −381]; C-peptide −1.42 nmol*h/L [−2.33, −0.51]). Fasting and postprandial lipid metabolism improved with semaglutide versus placebo. First-hour gastric emptying after the meal was delayed versus placebo (AUC0-1h; estimated treatment ratio: 0.73 [0.61, 0.87]); this may have contributed to the lower postprandial glucose increase in semaglutide-treated subjects. Overall gastric emptying (AUC0-5h) was not statistically different between treatments. Fasting and postprandial PYY responses were significantly lower with semaglutide versus placebo (p=0.0397 and p=0.0097, respectively). Conclusion: Semaglutide improved fasting and postprandial glucose and lipid metabolism. Overall gastric emptying was similar to placebo; however, the observed first-hour delay with semaglutide may contribute to a slower entry of glucose into the circulation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/) |
Keywords: | GLP‐1 analogue; glucose metabolism; incretin therapy; insulin analogues; obesity therapy; phase I‐II study |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Psychology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 27 Sep 2017 14:37 |
Last Modified: | 29 Mar 2018 11:29 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/dom.13120 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:121768 |
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