There is a marked and long-lasting improvement in glucose homeostasis that follows Roux-en-y gastric bypass surgery (RYGB) in humans. This improvement has been attributed in large part to an intestinal hormone, called GLP-1, that is released into the circulation immediately after eating. The purpose of this study is to determine if GLP-1 mediates the beneficial effects of RYGB surgery on glucose homeostasis in humans.
To conduct this study, we will enroll humans who previously underwent Roux-en-Y gastric bypass surgery, who are medically and weight stable and with no signs of type 2 diabetes either before or after surgery. Potential subjects will first be screened for eligibility and also to verify that they can safely participate in the study. Each study subject will be administered a meal tolerance test (MTT) on 3 separate occasions. For the MTT, a liquid meal (Boost Plus) will be ingested following an overnight fast. A primed-continuous infusion of vehicle alone (human albumin) or xenin-25 alone (at a dose of 4 or 12 pmoles x kg-1 x min-1) will be initiated 15 minutes before the meal is ingested. Blood samples will be collected before and during the MTT for the measurement of glucose and insulin levels, as well as a host of other hormones. A comparison of the results will tell us if the effects of xenin-25 on insulin release are mediated by GLP-1 in humans.
Study Type
INTERVENTIONAL
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
13
A liquid mixed meal containing 1.5 grams of acetaminophen will be ingested in 7 equal portions from 0-30 minutes. Starting at minus 15 minutes, an intravenous infusion of albumin alone (placebo) will be administered for 5.25 hours.
A liquid mixed meal containing 1.5 grams of acetaminophen will be ingested in 7 equal portions from 0-30 minutes. Starting at minus 15 minutes, an intravenous infusion of xenin-25 at a dose of 4 pmoles/kg/min will be administered for 5.25 hours.
A liquid mixed meal containing 1.5 grams of acetaminophen will be ingested in 7 equal portions from 0-30 minutes. Starting at minus 15 minutes, an intravenous infusion of xenin-25 at a dose of 12 pmoles/kg/min will be administered for 5.25 hours.
A liquid mixed meal containing 1.5 grams of acetaminophen will be ingested in 7 equal portions from 0-30 minutes. Starting at minus 15 minutes, an intravenous infusion of xenin-25 at a dose of 24 pmoles/kg/min will be administered for 5.25 hours.
Washington University School of Medicine
St Louis, Missouri, United States
Insulin secretion rates (ISRs) during each treatment
ISRs will be measured at various times before and after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
Plasma glucose levels during each treatment.
Plasma glucose levels will be measured at various times before and after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
Plasma glucagon levels during each treatment.
Plasma glucagon levels will be measured at various times before and after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
Plasma GLP-1 during each treatment.
Plasma GLP-1 levels will be measured at various times before and after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
Plasma C-peptide levels during each treatment.
Plasma C-peptide levels will be measured at various times before and after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
The rate of gastric emptying during each treatment.
The rate of gastric emptying will be estimated after ingestion of a liquid mixed meal.
Time frame: 5.5 hours
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