Environmental Science and Pollution Research

, Volume 26, Issue 3, pp 2864–2872 | Cite as

A low GLP-1 response among patients treated for acute organophosphate and carbamate poisoning: a comparative cross-sectional study from an agrarian region of Sri Lanka

  • Devarajan RathishEmail author
  • Indika Senavirathna
  • Channa Jayasumana
  • Suneth Agampodi
  • Sisira Siribaddana
Research Article


Higher incidence of diabetes along with increased use of pesticides is seen in Southeast Asia. Recent hypothesis postulated a link between acetylcholinesterase inhibitor insecticides and type 2 diabetes through the GLP-1 pathway. This study compares the GLP-1 response between groups with low and high red blood cell acetylcholinesterase (RBC-AChE) activity. A comparative cross-sectional study was conducted amongst patients who were within 3 months after an acute organophosphate or carbamate poisoning (acute group) and amongst vegetable farmers with low (chronic group) and high (control group) RBC-AChE activity. Acute (366 mU/μM Hb) and chronic (361 mU/μM Hb) groups had significantly lower RBC-AChE activity in comparison to the control (471 mU/μM Hb) group (P < 0.0001). Only the acute group, which has had atropine therapy, showed a significantly lower 120 min value in comparison to the control group (P = 0.0028). Also, the acute group had significantly low late (P = 0.0287) and total (P = 0.0358) responses of GLP-1 in comparison to the control group. The findings of the study allude towards attenuation of GLP-1 response amongst patients after acute organophosphate and carbamate poisoning. The possibility of an atropine-mediated attenuation of GLP-1 response was discussed.


Atropine Organophosphate Carbamate Diabetes mellitus Glucagon-like peptide-1 Incretin effect Acetylcholinesterase activity 

List of abbreviations






area under the curve


body mass index


Chronic Kidney Disease Epidemiology Collaboration


estimated glomerular filtration rate


enzyme-linked immunosorbent assay


glucose-dependent insulinotropic polypeptide


glucagon-like peptide-1


interquartile range


not applicable


oral glucose tolerance test


organophosphate insecticide


red blood cell


type 2 diabetes mellitus


area under the curve for total response


Authors’ contributions

DR conceived the idea of the study and all authors participated in designing the study. DR was involved in data collection and analysis. DR and IS were involved in biochemical analysis. All authors were involved in the interpretation of data. DR drafted the manuscript and IS, CJ, SA and SS critically revised it. All authors read and approved the final manuscript.

Funding information

The study was partially funded by the grant awarded by the Research, Publication & Higher Degrees Committee, Rajarata University of Sri Lanka to DR (grant number RJT/RP&HDC/2017/FMAS/R/01) and the sponsorship awarded to DR by the State Pharmaceutical Corporation, Sri Lanka. The above agents did not influence the design of the study, collection, analysis and interpretation of data or the writing of the manuscript.

Compliance with ethical standards

Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Ethical clearance was obtained from the Ethics Review Committee of Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka (ERC/2016/80). Institutional permission was obtained from the institutional heads of Teaching Hospital Anuradhapura and Base Hospital Thambuttegama. Informed written consent to participate was obtained from all participants. All necessary measures were taken to preserve participant’s privacy and confidentiality.

Consent for publication

Consent to publish the information provided by the participants was obtained, provided that it will not be possible to identify individual participants in any way.

Supplementary material

11356_2018_3818_MOESM1_ESM.xls (84 kb)
Online Resource 1 (XLS 83 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Devarajan Rathish
    • 1
    Email author
  • Indika Senavirathna
    • 2
  • Channa Jayasumana
    • 1
  • Suneth Agampodi
    • 3
  • Sisira Siribaddana
    • 4
  1. 1.Department of Pharmacology, Faculty of Medicine and Allied SciencesRajarata University of Sri LankaSaliyapuraSri Lanka
  2. 2.Department of Biochemistry, Faculty of Medicine and Allied SciencesRajarata University of Sri LankaSaliyapuraSri Lanka
  3. 3.Department of Community Medicine, Faculty of Medicine and Allied SciencesRajarata University of Sri LankaSaliyapuraSri Lanka
  4. 4.Department of Medicine, Faculty of Medicine and Allied SciencesRajarata University of Sri LankaSaliyapuraSri Lanka

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