The overall effect is to slow the rate of appearance ( Ra ) of glucose in the blood after eating; this is accomplished via coordinate slowing down gastric emptying, inhibition of digestive secretion [ gastric acid, pancreatic enzymes, and bile ejection ], and a resulting reduction in food intake.
42.
As to why this didn't affect " time to peak concentration ", or any of the other things, when there may be a difference in rate of emptying, bear in mind 2-6 hours is a fairly large range and the variance in gastric emptying probably isn't that high for the comparitive examples.
43.
It is in a class of drugs known as muscarinic receptor antagonists-acetylcholine being the neurotransmitter of the parasympathetic nervous system which initiates the rest-and-digest state ( as opposed to fight-or-flight ), resulting in an increase in gastric motility and digestion; whereas pirenzepine would inhibit these actions and cause decreased gastric motility leading to delayed gastric emptying and constipation.
44.
As such, PBPK modeling can be used, " inter alia ", to evaluate the involvement of carrier-mediated transport, clearance saturation, enterohepatic recirculation of the parent compound, extra-hepatic / extra-gut elimination; higher " in vivo " solubility than predicted " in vitro "; drug-induced gastric emptying delays; gut loss and regional variation in gut absorption.
45.
"' Omarigliptin "'( "'MK-3102 "') is a potent, long-acting oral antidiabetic drug of the DPP-4 inhibitor class used for once-weekly treatment of type 2 diabetes and currently under development by Merck & Co . It inhibits DPP-4 to increase incretin levels ( GLP-1 and GIP ), which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying and decreases blood glucose levels.
46.
The glycemic effect of foods depends on a number of factors, such as the type of starch ( amylose versus amylopectin ), physical entrapment of the starch molecules within the food, fat and protein content of the food and organic acids or their salts in the meal adding vinegar, for example, will lower the GI . The presence of fat or soluble dietary fiber can slow the gastric emptying rate, thus lowering the GI . In general, coarse, grainy breads with higher amounts of fiber have a lower GI value than white breads.
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