Glucose-lowering effects and mechanisms of the bile acid-sequestering resin sevelamer

Diabetes, Obesity & Metabolism
Andreas BrøndenFilip K Knop

Abstract

Sevelamer, a non-absorbable amine-based resin used for treatment of hyperphosphataemia, has been demonstrated to have a marked bile acid-binding potential alongside beneficial effects on lipid and glucose metabolism. The aim of this study was to investigate the glucose-lowering effect and mechanism(s) of sevelamer in patients with type 2 diabetes. In this double-blinded randomized controlled trial, we randomized 30 patients with type 2 diabetes to sevelamer (n = 20) or placebo (n = 10). Participants were subjected to standardized 4-hour liquid meal tests at baseline and after 7 days of treatment. The main outcome measure was plasma glucagon-like peptide-1 excursions as measured by area under the curve. In addition, blood was sampled for measurements of glucose, lipids, glucose-dependent insulinotropic polypeptide, C-peptide, glucagon, fibroblast growth factor-19, cholecystokinin and bile acids. Assessments of gastric emptying, resting energy expenditure and gut microbiota composition were performed. Sevelamer elicited a significant placebo-corrected reduction in plasma glucose with concomitant reduced fibroblast growth factor-19 concentrations, increased de novo synthesis of bile acids, a shift towards a more hydrophilic bile a...Continue Reading

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Citations

Oct 20, 2018·Expert Opinion on Drug Discovery·Henriette Holst NerildAndreas Brønden
Oct 21, 2019·The Journal of Clinical Endocrinology and Metabolism·Andreas Brønden, Filip K Knop
Feb 23, 2020·The Journal of Clinical Endocrinology and Metabolism·Lærke S GasbjergFilip K Knop
Dec 18, 2020·Current Opinion in Lipidology·Manon BalversMax Nieuwdorp
Nov 19, 2020·The Journal of Pharmacology and Experimental Therapeutics·Tamara R CastañedaThomas Hübschle
May 1, 2021·Nutrients·Chiara FaveroMaria Dolores Sanchez-Niño

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