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Type: Journal article
Title: Effect of lipase inhibition on gastric emptying of, and the glycemic and incretin responses to, an oil/aqueous drink in type 2 diabetes mellitus
Author: Pilichiewicz, A.
O'Donovan, D.
Feinle-Bisset, C.
Lei, Y.
Wishart, J.
Bryant, L.
Meyer, J.
Horowitz, M.
Jones, K.
Citation: Journal of Clinical Endocrinology and Metabolism, 2003; 88(8):3829-3834
Publisher: Endocrine Society
Issue Date: 2003
ISSN: 0021-972X
Statement of
A. Pilichiewicz, D. O’Donovan, C. Feinle, Y. Lei, J. M. Wishart, L. Bryant, J. H. Meyer, M. Horowitz, and K. L. Jones
Abstract: This study examined the effects of the lipase inhibitor, orlistat, on gastric emptying of, and the glycemic and incretin hormone responses to, a drink containing oil and glucose components in patients with type 2 diabetes. Seven patients (aged 58 +/- 5 yr), managed by diet alone, consumed 60 ml olive oil (labeled with 20 MBq (99m)Tc-V-thiocyanate) and 300 ml water containing 75 g glucose (labeled with 6 MBq (67)Ga-EDTA), on two occasions, with and without 120 mg orlistat, positioned in the left lateral decubitus position with their back against a gamma camera. Venous blood samples, for measurement of blood glucose and plasma insulin, glucagon-like peptide-1 and glucose-dependent insulintropic polypeptide were obtained immediately before, and after, the drink. Gastric emptying of both oil (P < 0.001) and glucose (P < 0.0005) was faster after orlistat compared with control. Postprandial blood glucose (P < 0.001) and plasma insulin (P < 0.05) were substantially greater after orlistat compared with control. In contrast, plasma glucagon-like peptide-1 (P < 0.005) and glucose-dependent insulintropic polypeptide (P < 0.05) were less after orlistat. In conclusion, inhibition of fat digestion, by orlistat, may exacerbate postprandial glycemia, as a result of more rapid gastric emptying and a diminished incretin response.
Keywords: Stomach; Autonomic Nervous System; Humans; Diabetes Mellitus, Type 2; Lactones; Gastric Inhibitory Polypeptide; Glucagon; Insulin; Lipase; Glucose; Blood Glucose; Dietary Fats; Peptides; Peptide Fragments; Enzyme Inhibitors; Gastric Emptying; Middle Aged; Female; Male; Glucagon-Like Peptide 1; Glucagon-Like Peptides; Hemodynamics
Rights: © 2003 by The Endocrine Society
RMID: 0020030063
DOI: 10.1210/jc.2003-030199
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Appears in Collections:Medicine publications

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