ABSTRACT:Liraglutide is a novel once-daily human glucagon-like peptide (GLP)-1 analog in clinical use for the treatment of type 2 diabetes. To study metabolism and excretion of [ , and some of the NEP degradation products eluted very close to both plasma metabolites. Three minor metabolites totaling 6 and 5% of the administered radioactivity were excreted in urine and feces, respectively, but no liraglutide was detected. In conclusion, liraglutide is metabolized in vitro by DPP-IV and NEP in a manner similar to that of native GLP-1, although at a much slower rate. The metabolite profiles suggest that both DPP-IV and NEP are also involved in the in vivo degradation of liraglutide. The lack of intact liraglutide excreted in urine and feces and the low levels of metabolites in plasma indicate that liraglutide is completely degraded within the body.
Dietary intake was recorded on 7-d food registers by 18 patients for 2 y after horizontal gastroplasty (GP) for morbid obesity. The aim was to evaluate diet compliance and nutritional safety. In accordance with prescriptions, frequency of meals increased and amounts of food decreased. Contrary to intentions, qualitative improvements were minor and transient resulting in a lasting fractional increase of patients with inadequate intakes of a wide range of nutrients. Protein malnutrition could not be detected from measurements of serum-albumin, plasma-prealbumin, or plasma retinol-binding globulin. Calcium was not included in the vitamin-mineral supplement and serum-Ca decreased. Despite thorough instruction, close follow-up, and gastrosurgery, there were no major qualitative dietary improvements. The study showed that bad compliance with an intended qualitative improvement of diet adds to the risks of being on a severely energy-restricted GP diet and increases the necessity for broad long-term supplements.
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