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The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study
OBJECTIVES: To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT). MATERIALS AND METHODS: Half of the drug-naive patients with T2DM were randomly ass...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Sociedade Brasileira de Endocrinologia e Metabologia
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832851/ https://www.ncbi.nlm.nih.gov/pubmed/35551683 http://dx.doi.org/10.20945/2359-3997000000478 |
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author | Schreiber, Cristina da Silva Rafacho, Alex Silverio, Renata Betti, Roberto Lerário, Antonio Carlos Lotenberg, Ana Maria Pita Rahmann, Klara de Oliveira, Carolina Piras Wajchenberg, Bernardo Léo da Luz, Protásio Lemos |
author_facet | Schreiber, Cristina da Silva Rafacho, Alex Silverio, Renata Betti, Roberto Lerário, Antonio Carlos Lotenberg, Ana Maria Pita Rahmann, Klara de Oliveira, Carolina Piras Wajchenberg, Bernardo Léo da Luz, Protásio Lemos |
author_sort | Schreiber, Cristina da Silva |
collection | PubMed |
description | OBJECTIVES: To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT). MATERIALS AND METHODS: Half of the drug-naive patients with T2DM were randomly assigned for treatment with 100 mg of sitagliptin, q.d., or placebo for 4 weeks and then submitted to 3 consecutive MTT intercalated every 48 h. The MTTs differed in terms of macronutrient composition, with 70% of total energy from carbohydrates, proteins, or lipids. After 4 weeks of washout, a crossover treatment design was repeated. Both patients and researchers were blinded, and a repeated-measures ANOVA was employed for statistical analysis. RESULTS: Sitagliptin treatment reduced but did not normalize fasting and post-meal glucose values in the three MTTs, with lowered area-under-glucose-curve values varying from 7% to 15%. The sitagliptin treatment also improved the insulinogenic index (+86%) and the insulin/glucose (+25%), glucagon-like peptide-1/glucose (+46%) incremental area under the curves. Patients with early T2DM maintained the lowest glucose excursion after a protein- or lipid-rich meal without any major change in insulin, C-peptide, glucagon, or NEFA levels. CONCLUSION: We conclude that sitagliptin treatment is tolerable and contributes to better control of glucose homeostasis in early T2DM, irrespective of macronutrient composition. The blood glucose excursion during meal ingestion is minimal in protein- or fat-rich meals, which can be a positive ally for the management of T2DM. Clinical trial no: NCT00881543 |
format | Online Article Text |
id | pubmed-9832851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Sociedade Brasileira de Endocrinologia e Metabologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-98328512023-03-14 The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study Schreiber, Cristina da Silva Rafacho, Alex Silverio, Renata Betti, Roberto Lerário, Antonio Carlos Lotenberg, Ana Maria Pita Rahmann, Klara de Oliveira, Carolina Piras Wajchenberg, Bernardo Léo da Luz, Protásio Lemos Arch Endocrinol Metab Original Article OBJECTIVES: To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT). MATERIALS AND METHODS: Half of the drug-naive patients with T2DM were randomly assigned for treatment with 100 mg of sitagliptin, q.d., or placebo for 4 weeks and then submitted to 3 consecutive MTT intercalated every 48 h. The MTTs differed in terms of macronutrient composition, with 70% of total energy from carbohydrates, proteins, or lipids. After 4 weeks of washout, a crossover treatment design was repeated. Both patients and researchers were blinded, and a repeated-measures ANOVA was employed for statistical analysis. RESULTS: Sitagliptin treatment reduced but did not normalize fasting and post-meal glucose values in the three MTTs, with lowered area-under-glucose-curve values varying from 7% to 15%. The sitagliptin treatment also improved the insulinogenic index (+86%) and the insulin/glucose (+25%), glucagon-like peptide-1/glucose (+46%) incremental area under the curves. Patients with early T2DM maintained the lowest glucose excursion after a protein- or lipid-rich meal without any major change in insulin, C-peptide, glucagon, or NEFA levels. CONCLUSION: We conclude that sitagliptin treatment is tolerable and contributes to better control of glucose homeostasis in early T2DM, irrespective of macronutrient composition. The blood glucose excursion during meal ingestion is minimal in protein- or fat-rich meals, which can be a positive ally for the management of T2DM. Clinical trial no: NCT00881543 Sociedade Brasileira de Endocrinologia e Metabologia 2022-05-12 /pmc/articles/PMC9832851/ /pubmed/35551683 http://dx.doi.org/10.20945/2359-3997000000478 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Schreiber, Cristina da Silva Rafacho, Alex Silverio, Renata Betti, Roberto Lerário, Antonio Carlos Lotenberg, Ana Maria Pita Rahmann, Klara de Oliveira, Carolina Piras Wajchenberg, Bernardo Léo da Luz, Protásio Lemos The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title | The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title_full | The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title_fullStr | The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title_full_unstemmed | The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title_short | The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
title_sort | effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832851/ https://www.ncbi.nlm.nih.gov/pubmed/35551683 http://dx.doi.org/10.20945/2359-3997000000478 |
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