Glycemic effects and safety of L-glutamine supplementation with or without sitagliptin in type 2 diabetes patients-a randomized study

Abstract

Background and Aims: L-glutamine is an efficacious glucagon-like peptide (GLP)-1 secretagogue in vitro. When administered with a meal, glutamine increases GLP-1 and insulin excursions and reduces postprandial glycaemia in type 2 diabetes patients. The aim of the study was to assess the efficacy and safety of daily glutamine supplementation with or without the dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin in well-controlled type 2 diabetes patients. Methods: Type 2 diabetes patients treated with metformin (n = 13, 9 men) with baseline glycated hemoglobin (HbA1c) 7.160.3% (5464 mmol/mol) received glutamine (15 g bd)+ sitagliptin (100 mg/d) or glutamine (15 g bd) + placebo for 4 weeks in a randomized crossover study. Results: HbA1c (P = 0.007) and fructosamine (P = 0.02) decreased modestly, without significant time-treatment interactions (both P = 0.4). Blood urea increased (P ,0.001) without a significant time-treatment interaction (P = 0.8), but creatinine and estimated glomerular filtration rate (eGFR) were unchanged (P0.5). Red blood cells, hemoglobin, hematocrit, and albumin modestly decreased (P#0.02), without significant time-treatment interactions (P0.4). Body weight and plasma electrolytes remained unchanged (P0.2). Conclusions: Daily oral supplementation of glutamine with or without sitagliptin for 4 weeks decreased glycaemia in wellcontrolled type 2 diabetes patients, but was also associated with mild plasma volume expansion. Trial Registration: ClincalTrials.gov NCT00673894