The acute effect of glucagon on components of energy balance and glucose homeostasis in adults without diabetes

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Title: The acute effect of glucagon on components of energy balance and glucose homeostasis in adults without diabetes
Authors: Frampton, J
Izzi-Engbeaya, C
Salem, V
Murphy, K
Tan, T
Chambers, E
Item Type: Journal Article
Abstract: Objective Using a systematic review and meta-analysis, we aimed to estimate the mean effect of acute glucagon administration on components of energy balance and glucose homeostasis in adults without diabetes. Methods CENTRAL, CINAHL, Embase, MEDLINE, PubMed, and Scopus databases were searched from inception to May 2021. To be included, papers had to be a randomised, crossover, single- or double-blind study, measuring ad libitum meal energy intake, energy expenditure, subjective appetite, glucose, and/or insulin following acute administration of glucagon and an appropriate comparator in adults without diabetes. Risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for Randomized trials with additional considerations for cross-over trials. Certainty of evidence was assessed using the GRADE approach. Random-effect meta-analyses were performed for outcomes with at least five studies. This study is registered on PROSPERO (CRD42021269623). Results 13 papers (15 studies) were considered eligible: energy intake (5 studies, 77 participants); energy expenditure (5 studies, 59 participants); subjective appetite (3 studies, 39 participants); glucose (13 studies, 159 participants); insulin (12 studies, 147 participants). All studies had some concerns with regards to risk of bias. Mean intervention effect of acute glucagon administration on energy intake was small (standardised mean difference [SMD]: -0.19; 95% CI, -0.59 to 0.21; P = 0.345). Mean intervention effect of acute glucagon administration on energy expenditure (SMD: 0.72; 95% CI, 0.37 to 1.08; P < 0.001), glucose (SMD: 1.11; 95% CI, 0.60 to 1.62; P < 0.001), and insulin (SMD: 1.33; 95% CI, 0.88 to 1.77; P < 0.001) was moderate to large. Conclusions Acute glucagon administration produces substantial increases in energy expenditure, and in circulating insulin and glucose concentrations. However, the effect of acute glucagon administration on energy intake is unclear. Insufficient evidence was available to evaluate the acute effect of glucagon on subjective appetite.
Date of Acceptance: 6-Sep-2022
URI: http://hdl.handle.net/10044/1/99623
ISSN: 0307-0565
Publisher: Springer Nature [academic journals on nature.com]
Journal / Book Title: International Journal of Obesity
Copyright Statement: This paper is embargoed until publication. Once published it will be available fully open access.
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: RDF01
Keywords: Endocrinology & Metabolism
11 Medical and Health Sciences
13 Education
Publication Status: Accepted
Embargo Date: This item is embargoed until publication
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Faculty of Medicine



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