A Protein Preload Enhances the Glucose-Lowering Efficacy of Vildagliptin in Type 2 Diabetes

• DOI: 10.2337/dc15-2298
• Publication Date: 2016-01-20T03:38:08Z
• Authors: Tongzhi Wu; Tanya J. Little; Michelle J. Bound; Malcolm Borg; Xiang Zhang; Carolyn F. Deacon; Michael Horowitz; Karen L. Jones; Christopher K. Ra...
• Keywords: Incretin; Vildagliptin

OBJECTIVE Nutrient “preloads” given before meals can attenuate postprandial glycemic excursions, at least partly by slowing gastric emptying and stimulating secretion of the incretins (i.e., glucagon-like peptide-1 [GLP-1] glucose-dependent insulinotropic polypeptide [GIP]). This study was designed to evaluate whether a protein preload could improve efficacy dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin increase incretin concentrations, slow emptying, lower glycemia in type 2 diabetes. RESEARCH DESIGN AND METHODS Twenty-two patients with diabetes treated metformin were studied on four occasions, receiving either 50 mg (VILD) or placebo (PLBO) both evening morning each day. The latter dose followed after 60 min drink containing 25 g whey (WHEY) control flavoring (CTRL), another 30 13C-octanoate–labeled mashed potato meal. Plasma glucose hormones, evaluated. RESULTS Compared PLBO/CTRL, PLBO/WHEY reduced peak glycemia, increased plasma insulin, glucagon, hormones (total intact), slowed whereas VILD/CTRL area under curve for glucose, intact incretins, but suppressed glucagon total (P < 0.05 each). VILD/CTRL, VILD/WHEY associated higher GLP-1 GIP, slower CONCLUSIONS In metformin-treated diabetes, has capacity enhance reduce glycemia.