Postprandial gallbladder emptying in patients with type 2 diabetes: potential implications for bile-induced secretion of glucagon-like peptide 1
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVE: Recent preclinical work has suggested that postprandial flow of bile acids into the small intestine potentiates nutrient-induced glucagon-like peptide 1 (GLP1(GCG)) secretion via bile acid-induced activation of the G protein-coupled receptor TGR5 in intestinal L cells. The notion of bile-induced GLP1 secretion combined with the findings of reduced postprandial gallbladder emptying in patients with type 2 diabetes (T2DM) led us to speculate whether reduced postprandial GLP1 responses in some patients with T2DM arise as a consequence of diabetic gallbladder dysmotility.
DESIGN AND METHODS: In a randomised design, 15 patients with long-standing T2DM and 15 healthy age-, gender- and BMI-matched control subjects were studied during 75-g oral glucose tolerance test (OGTT) and three isocaloric (500 kcal) and isovolaemic (350 ml) liquid meals: i) 2.5 g fat, 107 g carbohydrate and 13 g protein; ii) 10 g fat, 93 g carbohydrate and 11 g protein; and iii) 40 g fat, 32 g carbohydrate and 3 g protein. Basal and postprandial plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP1, glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin and gastrin were measured. Furthermore, gallbladder emptying and gastric emptying were examined.
RESULTS: Gallbladder emptying increased with increasing meal fat content, but no intergroup differences were demonstrated. GIP and GLP1 responses were comparable among the groups with GIP levels being higher following high-fat meals, whereas GLP1 secretion was similar after both OGTT and meals.
CONCLUSIONS: In conclusion, patients with T2DM exhibited normal gallbladder emptying to meals with a wide range of fat content. Incretin responses were similar to that in controls, and an association with postprandial gallbladder contraction could not be demonstrated.
|Journal||European Journal of Endocrinology|
|Number of pages||13|
|Publication status||Published - Oct 2014|
- Adult, Aged, Area Under Curve, Bile, Biological Markers, Blood Glucose, C-Peptide, Case-Control Studies, Cholecystokinin, Denmark, Diabetes Mellitus, Type 2, Dietary Fats, Female, Gallbladder Emptying, Gastric Emptying, Gastric Inhibitory Polypeptide, Gastrins, Glucagon, Glucagon-Like Peptide 1, Glucose Tolerance Test, Humans, Insulin, Male, Middle Aged, Postprandial Period, Receptors, G-Protein-Coupled