Wu, T.Bound, M.Zhao, R.Standfield, S.Bellon, M.Jones, K.Horowitz, M.Rayner, C.2013-11-112013-11-112013Diabetes Care, 2013; 36(7):1913-19180149-59921935-5548http://hdl.handle.net/2440/80832OBJECTIVE Macronutrient “preloads” can reduce postprandial glycemia by slowing gastric emptying and stimulating glucagon-like peptide-1 (GLP-1) secretion. An ideal preload would entail minimal additional energy intake and might be optimized by concurrent inhibition of dipeptidyl peptidase-4 (DPP-4). We evaluated the effects of a low-energy d-xylose preload, with or without sitagliptin, on gastric emptying, plasma intact GLP-1 concentrations, and postprandial glycemia in type 2 diabetes. RESEARCH DESIGN AND METHODS Twelve type 2 diabetic patients were studied on four occasions each. After 100 mg sitagliptin (S) or placebo (P) and an overnight fast, patients consumed a preload drink containing either 50 g d-xylose (X) or 80 mg sucralose (control [C]), followed after 40 min by a mashed potato meal labeled with 13C-octanoate. Blood was sampled at intervals. Gastric emptying was determined. RESULTS Both peak blood glucose and the amplitude of glycemic excursion were lower after PX and SC than PC (P < 0.01 for each) and were lowest after SX (P < 0.05 for each), while overall blood glucose was lower after SX than PC (P < 0.05). The postprandial insulin-to-glucose ratio was attenuated (P < 0.05) and gastric emptying was slower (P < 0.01) after d-xylose, without any effect of sitagliptin. Plasma GLP-1 concentrations were higher after d-xylose than control only before the meal (P < 0.05) but were sustained postprandially when combined with sitagliptin (P < 0.05). CONCLUSIONS In type 2 diabetes, acute administration of a d-xylose preload reduces postprandial glycemia and enhances the effect of a DPP-4 inhibitor.en© 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.HumansDiabetes Mellitus, Type 2TriazolesPyrazinesInsulinBlood GlucoseXyloseRadioimmunoassayEnzyme-Linked Immunosorbent AssayGastric EmptyingPostprandial PeriodAgedMiddle AgedFemaleMaleGlucagon-Like Peptide 1Dipeptidyl-Peptidase IV InhibitorsSitagliptin PhosphateJournal article002013079210.2337/dc12-22940003214727000202-s2.0-8488605080318675Wu, T. [0000-0003-1656-9210]Bound, M. [0000-0003-0211-5832]Jones, K. [0000-0002-1155-5816]Horowitz, M. [0000-0002-0942-0306]Rayner, C. [0000-0002-5527-256X]