The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects

Matheni Sathananthan,1 Sayeed Ikramuddin,2 James M Swain,3,6 Meera Shah,1 Francesca Piccinini,4 Chiara Dalla Man,4 Claudio Cobelli,4 Robert A Rizza,1 Michael Camilleri,5 Adrian Vella1 1Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division...

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Autores principales: Sathananthan M, Ikramuddin S, Swain JM, Shah M, Piccinini F, Dalla Man C, Cobelli C, Rizza RA, Camilleri M, Vella A
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Publicado: Dove Medical Press 2014
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spelling oai:doaj.org-article:fd4ead5d02854e55a829169f613092de2021-12-02T02:43:07ZThe effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects1178-7007https://doaj.org/article/fd4ead5d02854e55a829169f613092de2014-07-01T00:00:00Zhttp://www.dovepress.com/the-effect-of-vagal-nerve-blockade-using-electrical-impulses-on-glucos-a17558https://doaj.org/toc/1178-7007 Matheni Sathananthan,1 Sayeed Ikramuddin,2 James M Swain,3,6 Meera Shah,1 Francesca Piccinini,4 Chiara Dalla Man,4 Claudio Cobelli,4 Robert A Rizza,1 Michael Camilleri,5 Adrian Vella1 1Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division of General Surgery, University of Minnesota, Minneapolis, MN, USA; 3Division of General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA; 4Department of Information Engineering, University of Padua, Padua, Italy; 5Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA; 6Scottsdale Healthcare Bariatric Center, Scottsdale, AZ, USA Purpose: Vagal interruption causes weight loss in humans and decreases endogenous glucose production in animals. However, it is unknown if this is due to a direct effect on glucose metabolism. We sought to determine if vagal blockade using electrical impulses alters glucose metabolism in humans. Patients and methods: We utilized a randomized, cross-over study design where participants were studied after 2 weeks of activation or inactivation of vagal nerve blockade (VNB). Seven obese subjects with impaired fasting glucose previously enrolled in a long-term study to examine the effect of VNB on weight took part. We used a standardized triple-tracer mixed meal to enable measurement of the rate of meal appearance, endogenous glucose production, and glucose disappearance. The 550 kcal meal was also labeled with 111In-diethylene triamine pentaacetic acid (DTPA) to measure gastrointestinal transit. Insulin action and ß-cell responsivity indices were estimated using the minimal model. Results: Integrated glucose, insulin, and glucagon concentrations did not differ between study days. This was also reflected in a lack of effect on β-cell responsivity and insulin action. Furthermore, fasting and postprandial endogenous glucose production, integrated meal appearance, and glucose disposal did not differ in the presence or absence of VNB. Similarly, gastric emptying and colonic transit were unchanged by VNB. Conclusion: In this pilot study in nondiabetic humans, electrical vagal blockade had no acute effects on glucose metabolism, insulin secretion and action, or gastric emptying. It remains to be determined if more pronounced effects would be observed in diabetic subjects. Keywords: vagotomy, insulin secretion, insulin action, endogenous glucose productionSathananthan MIkramuddin SSwain JMShah MPiccinini FDalla Man CCobelli CRizza RACamilleri MVella ADove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2014, Iss default, Pp 305-312 (2014)
institution DOAJ
collection DOAJ
language EN
topic Specialties of internal medicine
RC581-951
spellingShingle Specialties of internal medicine
RC581-951
Sathananthan M
Ikramuddin S
Swain JM
Shah M
Piccinini F
Dalla Man C
Cobelli C
Rizza RA
Camilleri M
Vella A
The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
description Matheni Sathananthan,1 Sayeed Ikramuddin,2 James M Swain,3,6 Meera Shah,1 Francesca Piccinini,4 Chiara Dalla Man,4 Claudio Cobelli,4 Robert A Rizza,1 Michael Camilleri,5 Adrian Vella1 1Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division of General Surgery, University of Minnesota, Minneapolis, MN, USA; 3Division of General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA; 4Department of Information Engineering, University of Padua, Padua, Italy; 5Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA; 6Scottsdale Healthcare Bariatric Center, Scottsdale, AZ, USA Purpose: Vagal interruption causes weight loss in humans and decreases endogenous glucose production in animals. However, it is unknown if this is due to a direct effect on glucose metabolism. We sought to determine if vagal blockade using electrical impulses alters glucose metabolism in humans. Patients and methods: We utilized a randomized, cross-over study design where participants were studied after 2 weeks of activation or inactivation of vagal nerve blockade (VNB). Seven obese subjects with impaired fasting glucose previously enrolled in a long-term study to examine the effect of VNB on weight took part. We used a standardized triple-tracer mixed meal to enable measurement of the rate of meal appearance, endogenous glucose production, and glucose disappearance. The 550 kcal meal was also labeled with 111In-diethylene triamine pentaacetic acid (DTPA) to measure gastrointestinal transit. Insulin action and ß-cell responsivity indices were estimated using the minimal model. Results: Integrated glucose, insulin, and glucagon concentrations did not differ between study days. This was also reflected in a lack of effect on β-cell responsivity and insulin action. Furthermore, fasting and postprandial endogenous glucose production, integrated meal appearance, and glucose disposal did not differ in the presence or absence of VNB. Similarly, gastric emptying and colonic transit were unchanged by VNB. Conclusion: In this pilot study in nondiabetic humans, electrical vagal blockade had no acute effects on glucose metabolism, insulin secretion and action, or gastric emptying. It remains to be determined if more pronounced effects would be observed in diabetic subjects. Keywords: vagotomy, insulin secretion, insulin action, endogenous glucose production
format article
author Sathananthan M
Ikramuddin S
Swain JM
Shah M
Piccinini F
Dalla Man C
Cobelli C
Rizza RA
Camilleri M
Vella A
author_facet Sathananthan M
Ikramuddin S
Swain JM
Shah M
Piccinini F
Dalla Man C
Cobelli C
Rizza RA
Camilleri M
Vella A
author_sort Sathananthan M
title The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
title_short The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
title_full The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
title_fullStr The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
title_full_unstemmed The effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
title_sort effect of vagal nerve blockade using electrical impulses on glucose metabolism in nondiabetic subjects
publisher Dove Medical Press
publishDate 2014
url https://doaj.org/article/fd4ead5d02854e55a829169f613092de
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