Glucagon-Like Peptide 1 Attenuates the Acceleration of Gastric Emptying Induced by Hypoglycemia in Healthy Subjects

  1. Adam M. Deane1,2,3
  1. 1Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia
  2. 2Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia
  3. 3Centre for Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Adelaide, Australia
  4. 4Discipline of Medicine, University of Adelaide, Adelaide, Australia
  5. 5Diabetes Division, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
  1. Corresponding author: Mark P. Plummer, mark.philip.plummer{at}


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.

RESEARCH DESIGN AND 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 2 occasions [hypo]) or euglycemia (6.0 mmol/L on 2 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 99mTc-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.

  • Received August 1, 2013.
  • Accepted January 27, 2014.

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