{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:46:00Z","timestamp":1793763960899,"version":"4.6.1"},"reference-count":25,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100009727","name":"Hospital Research Foundation","doi-asserted-by":"publisher","award":["Mid-Career Fellowship"],"award-info":[{"award-number":["Mid-Career Fellowship"]}],"id":[{"id":"10.13039\/100009727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001786","name":"University of Adelaide","doi-asserted-by":"publisher","award":["William T Southcott Senior Research Fellowship"],"award-info":[{"award-number":["William T Southcott Senior Research Fellowship"]}],"id":[{"id":"10.13039\/501100001786","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004267","name":"Royal Adelaide Hospital","doi-asserted-by":"publisher","award":["Mary Overton Fellowship"],"award-info":[{"award-number":["Mary Overton Fellowship"]}],"id":[{"id":"10.13039\/501100004267","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020541","name":"Royal Adelaide Hospital Research Fund","doi-asserted-by":"publisher","award":["10953"],"award-info":[{"award-number":["10953"]}],"id":[{"id":"10.13039\/501100020541","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:p>Individuals with type 2 diabetes are at high risk of postprandial decrease in blood pressure (BP; i.e., a reduction in systolic BP of \u226520 mmHg, termed postprandial hypotension [PPH]), which increases the risk of falls and mortality. This study evaluated the effects of oral metformin on postprandial BP, heart rate (HR), glucagon-like peptide 1 (GLP-1), and gastric emptying (GE) in individuals with type 2 diabetes. We studied 16 patients (five women) before and after ingestion of a 75-g radiolabeled glucose drink, after both acute (30 min) and subacute (twice per day for 7 days) administration of metformin (850 mg) or placebo, according to a double-blind randomized crossover design. To quantify PPH events, 24-h ambulatory BP measurement after standardized meals (breakfast, lunch, and dinner) was used. The primary outcome was postprandial decrease in systolic BP. We found that acute administration of metformin did not affect BP, HR, plasma insulin, or GLP-1 levels but slowed GE (P &amp;lt; 0.001) and reduced glycemic response to oral glucose (P &amp;lt; 0.001). Subacute metformin increased HR (P = 0.029), slowed GE (P &amp;lt; 0.001), augmented plasma GLP-1 (P &amp;lt; 0.001) and reduced plasma glucose (P &amp;lt; 0.001) in response to oral glucose, without affecting plasma insulin. Moreover, subacute metformin reduced postprandial falls in systolic BP (P = 0.0002) and PPH events (P = 0.035) during ambulatory BP measurement. Preprandial BP was unaffected by metformin. To conclude, in type 2 diabetes, oral metformin attenuates the hypotensive response to meals, in association with stimulation of GLP-1 and slowing of GE, to reduce PPH.<\/jats:p>\n               <jats:sec>\n                  <jats:title>Article Highlights<\/jats:title>\n                  <jats:p>Postprandial hypotension (PPH) occurs frequently in type 2 diabetes. Metformin has cardiovascular effects independent of its glucose-lowering capacity, which may modulate the risk of PPH. We investigated the effects of metformin on postprandial blood pressure, including PPH events, heart rate, glucose, insulin, glucagon-like peptide 1 (GLP-1), and gastric emptying, in individuals with type 2 diabetes. Metformin attenuated postprandial decrease in blood pressure and reduced PPH events, in association with augmentation of\u00a0plasma GLP-1, slowed gastric emptying, and increased heart rate, in type 2 diabetes. These findings establish novel cardiovascular effects of metformin that may mitigate the risk of PPH in type 2 diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/db24-0830","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T19:34:02Z","timestamp":1736192042000},"page":"611-618","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":14,"title":["Effects of Metformin on Postprandial Blood Pressure, Heart Rate, Gastric Emptying, GLP-1, and Prevalence of Postprandial Hypotension in Type 2 Diabetes: A Double-Blind Placebo-Controlled Crossover Study"],"prefix":"10.2337","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-6846","authenticated-orcid":false,"given":"Daniel R.","family":"Quast","sequence":"first","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"},{"name":"2Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Xie","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Bound","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Grivell","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seva","family":"Hatzinikolas","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-5816","authenticated-orcid":false,"given":"Karen L.","family":"Jones","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horowitz","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5527-256X","authenticated-orcid":false,"given":"Christopher K.","family":"Rayner","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5749-6954","authenticated-orcid":false,"given":"Michael A.","family":"Nauck","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juris J.","family":"Meier","sequence":"additional","affiliation":[{"name":"3Department of Internal Medicine, Augusta-Hospital, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza K.","family":"Phillips","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1656-9210","authenticated-orcid":false,"given":"Tongzhi","family":"Wu","sequence":"additional","affiliation":[{"name":"1Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"2025032018521011500_B1","doi-asserted-by":"crossref","first-page":"813","DOI":"10.2337\/dc16-2736","article-title":"Cardiovascular disease and type 2 diabetes: has the dawn of a new era arrived?","volume":"40","author":"Abdul-Ghani","year":"2017","journal-title":"Diabetes Care"},{"key":"2025032018521011500_B2","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.jamda.2014.01.011","article-title":"Postprandial hypotension: a systematic review","volume":"15","author":"Trahair","year":"2014","journal-title":"J Am Med Dir Assoc"},{"key":"2025032018521011500_B3","doi-asserted-by":"crossref","first-page":"afae022","DOI":"10.1093\/ageing\/afae022","article-title":"Prevalence of postprandial hypotension in older adults: a systematic review and meta-analysis","volume":"53","author":"Huang","year":"2024","journal-title":"Age Ageing"},{"key":"2025032018521011500_B4","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1093\/ajcn\/nqac158","article-title":"Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality","volume":"116","author":"Jenkins","year":"2022","journal-title":"Am J Clin Nutr"},{"key":"2025032018521011500_B5","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/j.1532-5415.1997.tb05965.x","article-title":"Association of postprandial hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29-month follow-up in 499 older nursing home residents","volume":"45","author":"Aronow","year":"1997","journal-title":"J Am Geriatr Soc"},{"key":"2025032018521011500_B6","first-page":"244","article-title":"Longitudinal changes in the blood pressure responses to, and gastric emptying of, an oral glucose load in healthy older subjects","volume":"75","author":"Pham","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025032018521011500_B7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.diabres.2016.01.024","article-title":"Effect of duodenal glucose load on blood pressure in type 2 diabetes","volume":"113","author":"Marathe","year":"2016","journal-title":"Diabetes Res Clin Pract"},{"key":"2025032018521011500_B8","doi-asserted-by":"crossref","first-page":"582314","DOI":"10.3389\/fnut.2020.582314","article-title":"Comparative effects of intraduodenal glucose and fat infusion on blood pressure and heart rate in type 2 diabetes","volume":"7","author":"Xie","year":"2020","journal-title":"Front Nutr"},{"key":"2025032018521011500_B9","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.3390\/nu13082826","article-title":"Potential for gut peptide-based therapy in postprandial hypotension","volume":"13","author":"Borg","year":"2021","journal-title":"Nutrients"},{"key":"2025032018521011500_B10","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1111\/dom.13632","article-title":"Metformin attenuates the postprandial fall in blood pressure in type 2 diabetes","volume":"21","author":"Borg","year":"2019","journal-title":"Diabetes Obes Metab"},{"key":"2025032018521011500_B11","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3390\/ph13110410","article-title":"Gastrointestinal mechanisms underlying the cardiovascular effect of metformin","volume":"13","author":"Borg","year":"2020","journal-title":"Pharmaceuticals (Basel)"},{"key":"2025032018521011500_B12","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/dom.12812","article-title":"Metformin reduces the rate of small intestinal glucose absorption in type 2 diabetes","volume":"19","author":"Wu","year":"2017","journal-title":"Diabetes Obes Metab"},{"key":"2025032018521011500_B13","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1111\/dom.12697","article-title":"Involvement of glucagon-like peptide-1 in the glucose-lowering effect of metformin","volume":"18","author":"Bahne","year":"2016","journal-title":"Diabetes Obes Metab"},{"key":"2025032018521011500_B14","doi-asserted-by":"crossref","first-page":"6156","DOI":"10.1038\/s41598-019-42531-0","article-title":"Metformin acutely lowers blood glucose levels by inhibition of intestinal glucose transport","volume":"9","author":"Horakova","year":"2019","journal-title":"Sci Rep"},{"key":"2025032018521011500_B15","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/ajcn\/87.1.156","article-title":"Effects of intraduodenal glucose, fat, and protein on blood pressure, heart rate, and splanchnic blood flow in healthy older subjects","volume":"87","author":"Gentilcore","year":"2008","journal-title":"Am J Clin Nutr"},{"key":"2025032018521011500_B16","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/S0002-9149(99)00520-2","article-title":"Effects of postprandial walking exercise on meal-related hypotension in frail elderly patients","volume":"84","author":"Oberman","year":"1999","journal-title":"Am J Cardiol"},{"key":"2025032018521011500_B17","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1042\/cs0940065","article-title":"Rate of gastric emptying is a determinant of postprandial hypotension in non-insulin-dependent diabetes mellitus","volume":"94","author":"Jones","year":"1998","journal-title":"Clin Sci (Lond)"},{"key":"2025032018521011500_B18","doi-asserted-by":"crossref","first-page":"702","DOI":"10.2337\/dc16-2391","article-title":"Effects of vildagliptin and metformin on blood pressure and heart rate responses to small intestinal glucose in type 2 diabetes","volume":"40","author":"Wu","year":"2017","journal-title":"Diabetes Care"},{"key":"2025032018521011500_B19","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1210\/en.2013-1934","article-title":"GLP-1 receptor localization in monkey and human tissue: novel distribution revealed with extensively validated monoclonal antibody","volume":"155","author":"Pyke","year":"2014","journal-title":"Endocrinology"},{"key":"2025032018521011500_B20","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1111\/dom.13633","article-title":"Effects of lixisenatide on postprandial blood pressure, gastric emptying and glycaemia in healthy people and people with type 2 diabetes","volume":"21","author":"Jones","year":"2019","journal-title":"Diabetes Obes Metab"},{"key":"2025032018521011500_B21","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1007\/s00125-015-3638-0","article-title":"Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes","volume":"58","author":"Trahair","year":"2015","journal-title":"Diabetologia"},{"key":"2025032018521011500_B22","doi-asserted-by":"crossref","first-page":"101102","DOI":"10.1016\/j.molmet.2020.101102","article-title":"GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art","volume":"46","author":"Nauck","year":"2021","journal-title":"Mol Metab"},{"key":"2025032018521011500_B23","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/ejendo\/lvae095","article-title":"The role of glucagon-like peptide 1 in the postprandial effects of metformin in type 2 diabetes: a randomized crossover trial","volume":"191","author":"Hansen","year":"2024","journal-title":"Eur J Endocrinol"},{"key":"2025032018521011500_B24","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1210\/jc.2009-1503","article-title":"Endogenous glucagon-like peptide-1 slows gastric emptying in healthy subjects, attenuating postprandial glycemia","volume":"95","author":"Deane","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2025032018521011500_B25","doi-asserted-by":"crossref","first-page":"514","DOI":"10.3945\/ajcn.114.083246","article-title":"Effect of glucagon-like peptide-1 receptor antagonism on appetite and food intake in healthy men","volume":"100","author":"Steinert","year":"2014","journal-title":"Am J Clin Nutr"}],"container-title":["Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/74\/4\/611\/793861\/db240830.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/74\/4\/611\/793861\/db240830.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T23:30:37Z","timestamp":1742513437000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article\/74\/4\/611\/157655\/Effects-of-Metformin-on-Postprandial-Blood"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,6]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,1,6]]},"published-print":{"date-parts":[[2025,4,1]]}},"URL":"https:\/\/doi.org\/10.2337\/db24-0830","relation":{},"ISSN":["0012-1797","1939-327X"],"issn-type":[{"value":"0012-1797","type":"print"},{"value":"1939-327X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,6]]}}}