Horm Metab Res 2019; 51(04): 267-273
DOI: 10.1055/a-0818-6374
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Exenatide Delays Gastric Emptying in Patients with Type 2 Diabetes Mellitus but not in Those with Gastroparetic Conditions

Christelle Beti
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Bernd Stratmann
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Georgy Bokman
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Jens Dreier
2  Herz- und Diabeteszentrum NRW, Institut für Laboratoriums- und Transfusionsmedizin, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Michael Hauber
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Young Hee Lee-Barkey
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Manfred Fischer
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Cornelius Knabbe
2  Herz- und Diabeteszentrum NRW, Institut für Laboratoriums- und Transfusionsmedizin, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Diethelm Tschoepe
1  Herz- und Diabeteszentrum NRW, Diabeteszentrum, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
› Author Affiliations
Further Information

Publication History

received 10 August 2018

accepted 04 December 2018

Publication Date:
28 January 2019 (eFirst)

Abstract

The effect of the treatment with glucagon-like peptide (GLP)-1 receptor agonists on gastric emptying in patients with diabetes with and without gastroparesis is analysed. Patients with type 2 diabetes mellitus subjected to GLP-1 receptor agonist therapy with exenatide were examined before and shortly after initiation of treatment. Gastric half-emptying time was determined by 13C-octanoic breath test; routine laboratory parameter as well as active GLP-1, ghrelin, leptin, insulin, proinsulin and C-peptide levels were determined in fasting state as well as postprandial secretion within 1 h after a standardised meal. Thirty patients’ data sets were available for evaluation, of those 20 patients had no gastroparesis and 10 patients showed pathological results following the breath test. Gastric half-emptying time was prolonged in nearly all patients who presented without gastroparesis at initiation of treatment with GLP-1 receptor agonists, only 2 patients with pre-existing mild gastroparesis had worsening of gastric emptying. No effect was detected on leptin and ghrelin levels. Postprandial GLP-1 concentrations measured as AUC after meal decreased significantly. Fasting insulin and C-peptide levels increased significantly without effect on postprandial levels. Proinsulin levels – fasting as well as AUC – decreased non-significantly. Patients reported comparable perception of therapeutic effects. Treatment with GLP-1 receptor agonists may be applied in patients with pre-existing gastroparesis; no effect in terms of worsening of symptoms compared to those without gastroparesis was detected. Patients reported outcome was independent from underlying gastroparesis. Negative effects on gastric emptying were only detected in patients without or with mild gastroparesis.

*  Equal authorship: Christelle Beti and Bernd Stratmann.


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