Exendin-4 reduces fasting and postprandial glucose and decreases energy intake in healthy volunteers

Exendin-4 is a long-acting potent agonist of the glucagon-like peptide 1 (G LP-1) receptor and may be useful in the treatment of type 2 diabetes and ob esity. We examined the effects of an intravenous infusion of exendin-4 (0.0 5 pmol.kg(-1).min(-1)) compared with a control saline infusion in healthy v olunteers. Exendin-4 reduced fasting plasma glucose levels and reduced the peak change of postprandial glucose from baseline (exendin-4, 1.5 +/- 0.3 v s. saline, 2.2 +/- 0.3 mmol/l, P< 0.05). Gastric emptying was delayed, as m easured by the paracetamol absorption method. Volunteers consumed 19% fewer calories at a free-choice buffet lunch with exendin-4 (exendin-4, 867 +/- 79 vs. saline 1,075 +/- 93 kcal, P = 0.012), without reported side effects. Thus our results are in accord with the possibility that exendin-4 may be a potential treatment for type 2 diabetes, particularly for obese patients, because it acts to reduce plasma glucose at least partly by a delay in gas tric emptying, as well as by reducing calorie intake.