To Investigate the Impact of Oral Anticholinergics on Insulin Secretion in Subjects with Impaired Glucose Tolerance (IGT): A Retrospective Study

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Abstract (English)

Abstract
Aim: The aim of the present study was to investigate the impact of oral anticholinergics on insulin secretion in
subjects with impaired glucose tolerance (IGT), in comparison with volunteers having normal glucose tolerance
(NGT).
Material & Methods: This retrospective study was conducted in the Department of Pharmacology, ANMMCH,
Gaya, Bihar, India from November 2019 to October 2020, and recruited 30 IGT and 30 NGT subjects. An oral
glucose tolerance test (OGTT) was conducted twice in the absence and presence of hyoscine butyl-bromide
(HBB). The plasma glucose (PG) and insulin levels were serially estimated at 30-min increments for 2 h after the
OGTT. Early (ΔI30/ΔPG30) & late (insulin/PGAUC 60-120) phase insulin activity were assessed subsequently.
Results: In the present study, 60 subjects including 30 IGT (13 male/17 female, BMI: 26.4±2.4) and 30 NGT (15
male/15 female, BMI: 24±0.6) met the study requirements and completed the experimental protocol. In both the
groups, a higher proportion belonged to the “overweight” category. The effect of HBB in the IGT group was
examined in terms of pharmacodynamic parameters obtained during a 75 g OGTT (0–120 min). The presence of
HBB did not have an impact on their fasting PG and PG Cmax values. In the IGT group, the presence of HBB
had no effect on fasting insulin levels and insulin Cmax at t = 60 min. The addition of HBB also did not impact
on the insulin total AUC 0–120 min. The presence of HBB had no effect on fasting insulin levels (6.50 ± 1.32 vs.
5.70 ± 0.87 mIU/L) and insulin Cmax at t = 60 min. However, the addition of HBB significantly decreased the
insulin total AUC 0-120 min. In the NGT group, similar to the IGT group, the presence of HBB did not impact
on the plasma glucose-based parameters, for example, fasting PG.
Conclusion: Our study findings indicate that insulin secretion is influenced by cholinergic system and that oral
anticholinergics may attenuate the late phase insulin activity in varying degrees of glycemic status.