Intact Liver Innervation and Glucose and Glucagon-like Peptide-1 (GLP-1) Induced Insulin Secretion

University Hospital, Gentofte, Copenhagen

Status: Unknown

Conditions: Liver Transplantation

Treatments: Other: intravenous glucose; Other: oral glucose; Drug: dipeptidyl peptidase 4 (DPP4) inhibitor

Study type: Interventional

Funder types: Other

Identifiers

NCT01176708

Transplant isoglycemia (AP)

Details and patient eligibility

About

The aim of the study is to investigate the significance of intact nerve supply to the liver for the glucagon-like peptide-1 (GLP-1) induced insulin secretion.

The hypothesis is that the effects of GLP-1 is transmitted through the GLP-1 receptor and that these effects involve sensory afferent neurons, probably primarily parasympathetic.

Full description

GLP-1 is a potent enterogastron and incretin hormone. It is rapidly inactivated by dipeptidyl peptidase IV so only 10-15% enters the systemic circulation. This has led to the hypothesis that GLP-1 interact locally with afferent sensory nerve fibers.

The aim of this study is to investigate the significance of intact liver innervation for the GLP-1 induced insulin secretion in liver transplanted patients; kidney transplanted control patients matched for immunosuppressive treatment, age, gender and body weight; and ten control persons matched for age, gender and body weight.

The insulin secretion will be evaluated from blood samples that will be analyzed for insulin and c-peptide.

Enrollment: 30 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• normal fasting plasma glucose
• normal hemoglobin
• informed consent

Exclusion criteria

• type 1 diabetes mellitus or type 2 diabetes mellitus
• body mass index > 30
• inflammatory bowel disease
• intestinal surgery
• serum creatinine > 250 µM and/or albuminuria
• ALAT > 2 x normal value
• Severe cardiac insufficiency
• in treatment with medicine which cannot be paused for 12 hours

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 3 patient groups

Liver transplanted

Experimental group

Description:

10 Liver transplanted patients

Treatment:

Drug: dipeptidyl peptidase 4 (DPP4) inhibitor

Other: oral glucose

Other: intravenous glucose

Kidney transplanted

Experimental group

Description:

10 kidney transplanted individuals

Treatment:

Drug: dipeptidyl peptidase 4 (DPP4) inhibitor

Other: oral glucose

Other: intravenous glucose

Healthy controls

Experimental group

Description:

10 healthy controls

Treatment:

Drug: dipeptidyl peptidase 4 (DPP4) inhibitor

Other: oral glucose

Other: intravenous glucose