Abstract

Glucagon-like Peptide-1 mimetics increase insulin secretion and reduces body weight in humans. In lean, healthy cats, short-term treatment has produced similar results, whereas the effect in obese cats or with extended duration of treatment is unknown. Here, prolonged (12 weeks) treatment with the Glucagon-like Peptide-1 mimetic, exenatide, was evaluated in 12 obese, but otherwise healthy, client-owned cats. Cats were randomized to exenatide (1.0 μg/kg) or placebo treatment twice daily for 12 weeks. The primary endpoint was changes in insulin concentration; the secondary endpoints were glucose homeostasis, body weight, body composition as measured by dual-energy x-ray absorptiometry and overall safety. An intravenous glucose tolerance test (1 g/kg body weight) was conducted at week 0 and week 12. Exenatide did not change the insulin concentration, plasma glucose concentration or glucose tolerance (P>0.05 for all). Exenatide tended to reduce body weight on continued normal feeding. Median relative weight loss after 12 weeks was 5.1% (range 1.7 to 8.4%) in the exenatide group versus 3.2% (range -5.3 to 5.7%) in the placebo group (P = 0.10). Body composition and adipokine levels were unaffected by exenatide (P>0.05). Twelve weeks of exenatide was well-tolerated, with only two cases of mild, self-limiting gastrointestinal signs and a single case of mild hypoglycemia. The long-term insulinotropic effect of exenatide appeared less pronounced in obese cats compared to previous short-term studies in lean cats. Further investigations are required to fully elucidate the effect on insulin secretion, glucose tolerance and body weight in obese cats.

Highlights

  • Glucagon-like Peptide-1 (GLP-1) is a protein secreted from the L-cells in the distal small intestine in response to the presence and absorption of nutrients in the gut lumen and GLP-1 amplifies glucose-induced insulin secretion[1]

  • But two cats dropped out before day seven due to aggression towards the owners during injections, and per protocol these cats were not included in any of the statistical analyses and will not be further discussed. Another two cats were withdrawn after 4 and 8 weeks respectively for the same reason. Both cats completed an intravenous glucose tolerance test (IVGTT) at the time of withdrawal and the results are included in the final analysis

  • The main findings of this study were: (i) the insulin potentiating effect of chronic exenatide treatment in obese cats varied among individuals, and appeared less pronounced compared to previous studies in purpose-bred lean cats, (ii) there was a trend for a weight loss effect in exenatide treated obese cats even without dietary changes, (iii) 12 weeks of treatment with exenatide was well tolerated in obese, but otherwise healthy, cats

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Summary

Introduction

Glucagon-like Peptide-1 (GLP-1) is a protein secreted from the L-cells in the distal small intestine in response to the presence and absorption of nutrients in the gut lumen and GLP-1 amplifies glucose-induced insulin secretion (the incretin effect)[1]. Endogenous GLP-1 has a plasma half-life of 1–2 min, due to a rapid degradation and inactivation by the enzyme dipeptidyl peptidase IV (DPP-IV), rendering natural GLP-1 impractical for diabetic treatment[1]. Exenatide is a synthetic GLP-1 mimetic and a potent GLP-1 receptor agonist with a half-life of 3–4 h after subcutaneous injection in humans due to DPP-IV resistance[2, 3]. GLP-1 mimetics increase insulin secretion, improve insulin sensitivity, reduce fasting blood glucose and decrease plasma glucagon levels in diabetic and non-diabetic human subjects[4,5,6,7]. GLP-1 mimetics decrease body weight in obese, non-diabetic and diabetic human patients through increased satiety, reduced appetite and slowed gastric emptying[6,7,8,9]. Exenatide treatment may cause hypoglycemia if combined with other anti-hyperglycaemic treatments such as biguanides or sulfonylureas[10]

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