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Impact of Anticholinergics on Insulin Response to Oral Glucose Load in Patients with Impaired Glucose Tolerance
Background/Objective(s): Postprandial insulin secretion is determined by rate of glucose absorption, rate of gastric emptying, and the rate of insulin-driven metabolism via ‘incretins’. Preliminary data in healthy individuals have indicated a cholinergic basis to incretin-effect however no data exists in patient with impaired glucose tolerance (IGT). We aimed study insulin responses in IGT subjects and healthy controls during 75 g oral glucose tolerance test (OGTT), using an oral anticholinergic hyoscine butyl-bromide (HBB). HBB has high affinity for muscarinic receptors of GI tract smooth muscles and has strong …show more content…

Following screening of 25 subjects, 10 impaired glucose tolerance (IGT) patients met study requirements. 10 age, gender and weight match healthy subjects were selected as comparator. In females, all tests were performed within 10 d of the anticipated onset of menses. Baseline characteristics of study participants have been described in Table 1.0.
Samples size of this study was chosen on the basis of practical considerations rather than statistical estimation. However, according to our experience, the calculated sample size will most likely allow to detect large differences (if any) in parameters (> 50%) between the treatments groups.
Protocol & Sampling
The study was conducted as randomized, open label, parallel-group trial. Subjects (n= 20) were asked to avoid any strenuous exercise and maintain their customary dietary intake for 48 h prior to testing days. After an 8h overnight fasting, all tests began after cannulation of the cubital vein kept patent by slow infusion of isotonic saline. They underwent an OGTT (glucose 75 g; t =0 min) with and without pretreatment with HBB (20 mg PO single dose; at t = -30 min) three days apart. Serial blood samples were collected at 0, 30, 60, 90 & 120 min for PG and insulin estimation. Changes in vital signs were monitored throughout test procedure, on both test days.
Blood samples were then collected in glass tubes and

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