Bile Acid Sequestrant Reduces Glucose Concentration in T2DM

For type 2 patients on metformin monotherapy, the bile acid sequestrant colesevelam reduces fasting and postprandial glucose concentrations without any effects on insulin concentration, secretion, or action, according to research.

 

Galina Smushkin, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues conducted a double-blind, placebo-controlled, parallel-group study of the effect of the bile acid sequestration colesevelam on glucose metabolism in 38 patients with type 2 diabetes who were taking metformin monotherapy. To measure the rate of meal appearance, endogenous glucose production, and glucose disappearance, participants underwent testing before and after 12 weeks of colesevelam or placebo using a labeled triple-tracer mixed meal.

 

The researchers found that colesevelam treatment correlated with significantly lower fasting and postprandial glucose concentrations, without any change in insulin concentration, secretion, or action. The treatment was not associated with changes in postprandial concentrations of glucagon-like peptide-1 (GLP-1) and was associated with no change in endogenous glucose production and glucose disappearance but was linked to a decrease in the rate of meal appearance.

 

The study demonstrated an effect of colesevelam on both fasting and postprandial glucose concentrations," the authors write. "Measurement of insulin secretion and action using the oral labeled and unlabeled minimal model failed to show a significant effect on insulin secretion and action. Moreover, there was no evidence that glucose lowering is produced by alterations in GLP-1 concentrations."