The effect of encapsulated glutamine on gut peptide secretion in human volunteers

Highlights • Weight loss and improved glucose tolerance after bariatric surgery have been attributed to delivery of nutrients to the lower parts of the gut. • Ileal-release of encapsulated nutrients therefore provides a potential avenue for non-surgical treatment of obesity. • In a randomised, controlled, blinded clinical study, we assessed the ability of encapsulated ileal-release glutamine to increase concentrations of total glucagon-like peptide 1 (GLP-1), improve glucose tolerance and reduce meal size. • Encapsulated glutamine did not provide consistent clinically or statistically significant increases in total GLP-1 in healthy volunteers or patients with type 2 diabetes and did not improve glucose tolerance. • We concluded that higher affinity nutrient agonists may be required to promote GLP-1 secretion.
Context Weight loss and improved blood glucose control after bariatric surgery have been attributed in part to increased ileal nutrient delivery with enhanced release of glucagon-like peptide 1 (GLP-1). Non-surgical strategies to manage obesity are required. The aim of the current study was to assess whether encapsulated glutamine, targeted to the ileum, could increase GLP-1 secretion, improve glucose tolerance or reduce meal size. Methods A single-center, randomised, double blind, placebo-controlled, cross-over study was performed in 24 healthy volunteers and 8 patients with type 2 diabetes. Fasting participants received a single dose of encapsulated ileal-release glutamine (3.6 or 6.0 g) or placebo per visit with blood sampling at baseline and for 4 h thereafter. Glucose tolerance and meal size were studied using a 75 g oral glucose tolerance test and ad libitum meal respectively. Results In healthy volunteers, ingestion of 6.0 g glutamine was associated with increased GLP-1 concentrations after 90 min compared with placebo (mean 10.6 pg/ml vs 6.9 pg/ml, p = 0.004), increased insulin concentrations after 90 min (mean 70.9 vs 48.5, p = 0.048), and increased meal size at 120 min (mean 542 g eaten vs 481 g, p = 0.008). Ingestion of 6.0 g glutamine was not associated with significant differences in GLP-1, glucose or insulin concentrations after a glucose tolerance test in healthy or type 2 diabetic participants. Conclusions Single oral dosing of encapsulated glutamine did not provoke consistent increases in GLP-1 and insulin secretion and was not associated with beneficial metabolic effects in healthy volunteers or patients with type 2 diabetes.