Elucidating the glucose‐lowering effect of the bile acid sequestrant sevelamer
Authors' conclusion
The bile acid sequestrant sevelamer improved insulin sensitivity and beta-cell sensitivity to glucose, but using the GLP-1 receptor antagonist exendin(9-39)NH2 we were not able to detect a GLP-1-mediated glucose-lowering effect of sevelamer in individuals with type 2 diabetes. Nevertheless, the sevelamer-induced improvement of beta-cell sensitivity to glucose was shown to be GLP-1-dependent.
Study context
- Population
- People with T2D on metformin monotherapycrossover
- Participants
- 15 people
- Comparison
- Sevelamer vs placebo, each with exendinNH2 or saline infusion
Methodological detailsdouble-blind, placebo-controlled, crossover, 4-h liquid meal tests with exendin(9-39)NH2 or saline infusion; wash-out ≥6 weeks
- Double-blind
- Placebo-controlled
- Crossover
- 4-h liquid meal tests with exendin(9-39)NH2 or saline infusion; wash-out ≥6 weeks
Primary result
As reported in the abstract
days 15 and 17 of each period
- Sevelamer vs placebo improved insulin sensitivity (HOMA-IR) and beta-cell sensitivity to glucose
- Sevelamer vs placebo lowered fasting and postprandial plasma glucose
- Exendin(9-39)NH2 increased postprandial glucose excursions vs saline in both periods, without absolute or relative difference between periods
- Exendin(9-39)NH2 abolished the sevelamer-induced improvement in beta-cell glucose sensitivity
Original publication
Elucidating the glucose‐lowering effect of the bile acid sequestrant sevelamer. Diabetes Obes Metab. Published 27 December 2023. doi:10.
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