Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Abstract

AIMS To determine the effects of the dipeptidyl peptidase‐4 inhibitor, sitagliptin, on gastric emptying of a high carbohydrate meal and associated glycaemic and blood pressure responses in type 2 diabetes mellitus. MATERIALS AND METHODS Fourteen patients with type 2 diabetes (9 male, 5 female; age: 67.8±1.5 years; BMI: 31.2±0.9 kg/m2; diabetes duration: 4.2±0.9 years; HbA1c: 46±1.8 mmol/mol (6.4±0.2%), managed by diet and/or metformin, underwent concurrent measurements of gastric emptying, blood pressure and plasma glucose for 240 min after ingestion of a radiolabelled a mashed potato meal after receiving sitagliptin (100 mg) or placebo in randomised, double‐blind, crossover fashion on two consecutive days. RESULTS Sitagliptin reduced postprandial plasma glucose (P<0.005), without affecting gastric emptying (P=0.88). The magnitude of the glucose‐lowering effect (change in iAUC0‐240 min from placebo to sitagliptin) was related to gastric emptying (kcal/min) on placebo (r=0.68, P=0.008) There was a comparable fall in systolic blood pressure (P=0.80) following the meal without any difference between the two days. CONCLUSIONS In type 2 diabetes, while sitagliptin has no effect on either gastric emptying or postprandial blood pressure, it's effects to lower postprandial glucose is dependent on the basal rate of gastric emptying