Challenge

Postprandial hypotension (PPH) is an important, but still poorly appreciated, clinical disorder characterised by a substantial fall in blood pressure after meals. PPH occurs frequently in people with type 2 diabetes (~25 to 40%) and can lead to fainting, falls, stroke and angina, and thereby affect quality of life adversely. There is currently no effective treatment for PPH.

Professor Karen Jones, a Senior Research Fellow, with a background in nuclear medicine at Adelaide University, is funded by Diabetes Australia to extend her research in this area. While the pathophysiology of PPH has been poorly defined, Professor Jones and her research team have shown that the fall in blood pressure after a meal is greater when the rate at which the stomach empties food is relatively faster.  

Bold idea

A widely used glucose-lowering medication, the GLP-1 receptor agonist, semaglutide sc, may slow stomach emptying. However, most research in this area has not used the ‘gold standard’ nuclear medicine technique to measure stomach emptying. Slowing stomach emptying is also likely to contribute to the potent effects of semaglutide sc to reduce blood sugar levels after meals and diminish appetite – this effect also has the potential to reduce the magnitude of the fall in blood pressure following meals. 

Impact  

A better understanding of the effects of semaglutide sc on stomach emptying in people living with type 2 diabetes may establish its potential as a treatment for PPH and improve understanding relevant to the more personalised and effective use of this medication, including in relation to procedures which require fasting, such as surgery and endoscopy.