Colesevelam has no acute effect on postprandial GLP-1 levels but abolishes gallbladder refilling
Authors' conclusion
Single-dose colesevelam had no effect on postprandial GLP-1 responses or glucose tolerance but disrupted postprandial gallbladder refilling by increasing CCK secretion and reducing circulating concentrations of FGF19 and bile acids. These findings leave the antidiabetic actions of colesevelam unresolved but provide mechanistic insights into its effect on gallbladder motility.
Study context
- Population
- Individuals with T2D (mean ± SD age 61 ± 8.8 years; BMI 29.8 ± 3.0 kg/m²); 4 mixed meal tests on separate dayscrossover
- Participants
- 12 individuals
- Comparison
- Single-dose colesevelam vs placebo, with exendinNH2 or saline infusion
- Primary endpoint
- Postprandial GLP-1 secretion and postprandial glucose excursions
Methodological detailsdouble-blind, placebo-controlled, crossover
- Double-blind
- Placebo-controlled
- Crossover
Primary result
As reported in the abstract
Postprandial glucose, C-peptide and GLP-1
- Exendin(9-39)NH2 administration revealed no GLP-1-mediated effects of colesevelam
- Colesevelam vs Placebo: P = 0.786
- Colesevelam vs Placebo: P = 0.440
- Colesevelam vs Placebo: P = 0.729
Further findings
| Outcome | P value |
|---|---|
| Gallbladder motility (US)Gallbladder refilling abolished | P = 0.001 |
| Postprandial CCK, FGF19 and bile acidsColesevelam vs Placebo · CCK secretion increased | P = 0.010 |
| Postprandial CCK, FGF19 and bile acidsColesevelam vs Placebo · serum FGF19 decreased | P = 0.035 |
| Postprandial CCK, FGF19 and bile acidsColesevelam vs Placebo · serum bile acids decreased | P = 0.043 |
Gallbladder motility (US)
- Colesevelam did not affect gallbladder emptying
Original publication
Colesevelam has no acute effect on postprandial GLP-1 levels but abolishes gallbladder refilling. Eur J Endocrinol. Published 29 March 2024. doi:10.
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