Effect of Bile Acid Secretion and Sequestration on GLP-1 Secretion
Status:
Completed
Trial end date:
2016-07-01
Target enrollment:
Participant gender:
Summary
Accumulating evidence suggests that bile acids in our intestines may constitute essential
components in the complex mechanisms regulating gut hormone secretion and glucose
homeostasis. Thus, it is likely that modification of the enterohepatic circulation of bile
acids can lead to changes in gut hormone secretion and consequently affect glucose
homeostasis.
The current study is a human interventional randomized controlled cross-over study including
four study days for each participant. As a tool to sequester bile acids we will use
sevelamer, a phosphate binding resin used in the treatment of hyperphosphataemia in adult
patients with chronic kidney disease. Surprisingly, sevelamer has been shown to improve
glycaemic control in patients with chronic kidney disease and type 2 diabetes. Intravenous
infusion of cholecystokinin will be used to elicit gallbladder contraction and emptying. The
aim is to examine how (and if) bile acid sequestration can influence postprandial
glucagon-like peptide-1 (GLP-1) secretion and glucose homeostasis in patients with type 2
diabetes.
The investigators hypothesize that higher luminal concentrations of bile acids in the distal
gut will elicit changes in gut hormone secretion. The current study will help to clarify this
hypothesis and improve our general understanding of the association between bile acid
circulation and signalling, gut hormone secretion and glucose metabolism.