Background: Preliminary data indicates there is a cholinergic basis to insulin secretion.
Aims & Objective: 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 prospective observational study recruited 10 IGT and 10 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: The study constituted of 10 IGT (4M/6F, BMI:
28.80 ± 2.30) and 10 NGT (5M/5F, BMI: 23.00 ± 0.80) subjects. In the NGT group, the pre‑HBB mean
glucose levels (0‑120 min) were comparable with those recorded after HBB intake. However, after
HBBB, the mean insulin levels decreased significantly at t = 90 and 120min, confirmed by attenuated
late phase insulin activity in IGT (P = 0.023) & NGT (P = 0.006) group. On the other hand, in the IGT
group, however, HBB did not impact on the mean PG and insulin levels (0‑120 min).Conclusions:
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.