Effects of lixisenatide on postprandial blood pressure, gastric emptying and glycemia in health and type 2 diabetes.

AimTo evaluate the effects of the prandial glucagon-like peptide-1 receptor agonist lixisenatide on gastric emptying and blood pressure (BP) and superior mesenteric artery (SMA) blood flow, and the glycaemic responses to a 75-g oral glucose load in healthy people and those with type 2 diabetes (T2DM). Materials and methodsFifteen healthy participants (nine men, six women; meanSEM age 67.22.3years) and 15 participants with T2DM (nine men, six women; mean +/- SEM age 61.9 +/- 2.3years) underwent measurement of gastric emptying, BP, SMA flow and plasma glucose 180minutes after a radiolabelled 75-g glucose drink on two separate days. All participants received lixisenatide (10g subcutaneously) or placebo in a randomized, double-blind, crossover fashion 30minutes before the glucose drink. ResultsLixisenatide slowed gastric emptying (retention at 120minutes, P<0.01), attenuated the rise in SMA flow (P<0.01) and markedly attenuated the decrease in systolic BP (area under the curve [AUC] 0-120minutes, P<0.001) compared to placebo in healthy participants and those with T2DM. Plasma glucose (incremental AUC 0-120minutes) was greater in participants with T2DM (P<0.005) than in healthy participants, and lower after lixisenatide in both groups (P<0.001). ConclusionsIn healthy participants and those with T2DM, the marked slowing of gastric emptying of glucose induced by lixisenatide was associated with attenuation of the increments in glycaemia and SMA flow and decrease in systolic BP. Accordingly, lixisenatide may be useful in the management of postprandial hypotension.