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

Matheni Sathananthan, Sayeed Ikramuddin, James M. Swain, Meera Shah, Francesca Piccinini, Chiara Dalla Man, Claudio Cobelli, Robert A. Rizza, Michael Camilleri, Adrian Vella

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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 β-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.

Original languageEnglish (US)
Pages (from-to)305-312
Number of pages8
JournalDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Volume7
DOIs
StatePublished - Jul 11 2014

Keywords

  • Endogenous glucose production
  • Insulin action
  • Insulin secretion
  • Vagotomy

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