Original Article

European Journal of Clinical Nutrition (2007) 61, 1364–1372; doi:10.1038/sj.ejcn.1602654; published online 14 February 2007

Glucagon-like peptide-1 (7–36) amide response to low versus high glycaemic index preloads in overweight subjects with and without type II diabetes mellitus

Guarantor: GS Frost.

Contributors: JEM was responsible for the experimental design, subject recruitment, data collection and analysis, biochemical analysis and writing of the paper. CSS was responsible for data collection and some biochemical analysis. MP and MAG were responsible for biochemical analysis. GSF and SRB were responsible for experimental design and data analysis.

J E Milton1, C S Sananthanan1, M Patterson2, M A Ghatei2, S R Bloom2 and G S Frost1

  1. 1Nutrition and Dietetic Research Group, Hammersmith Hospital, London, UK
  2. 2Endocrine Unit, Imperial College Faculty of Medicine, Hammersmith Hospital, London, UK

Correspondence: Dr GS Frost, Nutrition and Dietetics Department, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK. E-mail: G.Frost@imperial.ac.uk

Received 14 November 2005; Revised 19 June 2006; Accepted 14 November 2006; Published online 14 February 2007.

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Abstract

Background and objective:

 

Glucagon-like-peptide-1 (7–36) amide (GLP-1) is an insulin secretagogue and potential treatment for type II diabetes mellitus. An alternative to GLP-1 administration is endogenous dietary stimulation. We described a greater GLP-1 release following ingestion of liquids versus solids. We add to this work studying the effect of fluid preloads with differing glycaemic indices (GI) on the metabolic response to a meal.

Subjects and design:

 

GLP-1, insulin and glucose responses were measured in six overweight individuals and six subjects with type II diabetes on three occasions, after preload (milk, low GI; Ovaltine Light, high GI; or water, non-nutritive control) and meal ingestion.

Results:

 

In people with and without diabetes, the high GI preload produced the greatest glucose incremental area under the curve (IAUC)0–20, followed by the low GI preload, and water (P<0.001). In both groups, insulin IAUC0–20 was higher following high and low GI preloads compared with water (NS). In people without diabetes, the GLP-1 response was higher when high and low GI preloads were consumed compared with water (P=0.041), with no significant difference between nutritive preloads. GLP-1 response did not differ between preloads in people with diabetes. Despite initial differences, total IAUCs0–200 for biochemical variables did not differ by preload.

Conclusion:

 

We confirm that nutritive liquids stimulate GLP-1 to a greater extent than water in subjects without diabetes; however, this does not influence subsequent meal-induced response. The GI of preloads does not influence the degree of GLP-1 stimulation.

Keywords:

glycaemic index, preload, glucagon-like peptide-1, type II diabetes, gastric emptying

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