Glucagon-like peptide-1 does not have acute effects on central or renal hemodynamics in patients with type 2 diabetes without nephropathy

• Published in: American journal of physiology: endocrinology and metabolism 2016-05, Vol.310 (9), p.E744-E753
• Main Authors: Asmar, Ali, Simonsen, Lene, Asmar, Meena, Madsbad, Sten, Holst, Jens J, Frandsen, Erik, Moro, Cedric, Sorensen, Charlotte M, Jonassen, Thomas, Bülow, Jens
• Format: Article
• Language: English
• Subjects: Blood pressure; Blood Pressure - drug effects; Cardiac Output - drug effects; Diabetes; Diabetes Mellitus, Type 2; Glomerular Filtration Rate - drug effects; Glucagon-Like Peptide 1 - pharmacology; Heart rate; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; Infusions, Intravenous; Kidney - blood supply; Kidney - drug effects; Kidney - metabolism; Male; Middle Aged; Natriuresis - drug effects; Peptides; Physiology; Renal Plasma Flow - drug effects; Sodium - urine
• ISSN: 0193-1849; 1522-1555
• DOI: 10.1152/ajpendo.00518.2015

During acute administration of native glucagon-like peptide-1 (GLP-1), we previously demonstrated central hemodynamic effects in healthy males, whereas renal hemodynamics, despite renal uptake of GLP-1 in excess of glomerular filtration, was unaffected. In the present study, we studied hemodynamic effects of GLP-1 in patients with type 2 diabetes under fixed sodium intake. During a 3-h infusion of GLP-1 (1.5 pmol·kg(-1)·min(-1)) or saline, intra-arterial blood pressure and heart rate were measured continuously, concomitantly with cardiac output estimated by pulse contour analysis. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured using Fick's Principle after catheterization of a renal vein. Urine collection was conducted throughout the experiments at voluntary voiding, and patients remained supine during the experiments. During the GLP-1 infusion, systolic and diastolic blood pressure and cardiac output remained unchanged, whereas heart rate increased significantly. Arterio-venous gradients for GLP-1 exceeded glomerular filtrations significantly, but renal plasma flow and glomerular filtration rate as well as renal sodium and lithium excretion were not affected. In conclusion, acute administration of GLP-1 in patients with type 2 diabetes leads to a positive chronotropic effect, but in contrast to healthy individuals, cardiac output does not increase in patients with type 2 diabetes. Renal hemodynamics and sodium excretion are not affected.