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https://hdl.handle.net/2440/92555
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dc.contributor.author | Perano, S. | - |
dc.contributor.author | Couper, J. | - |
dc.contributor.author | Horowitz, M. | - |
dc.contributor.author | Martin, A. | - |
dc.contributor.author | Kritas, S. | - |
dc.contributor.author | Sullivan, T. | - |
dc.contributor.author | Rayner, C. | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Journal of Clinical Endocrinology and Metabolism, 2014; 99(7):2486-2493 | - |
dc.identifier.issn | 0021-972X | - |
dc.identifier.issn | 1945-7197 | - |
dc.identifier.uri | http://hdl.handle.net/2440/92555 | - |
dc.description | Published Online: March 26, 2014 | - |
dc.description.abstract | CONTEXT: Cystic fibrosis-related diabetes is characterized by postprandial, rather than fasting, hyperglycemia. Gastric emptying and the release of the incretin hormones [glucagon-like peptide-1 (GLP-1) and glucose dependent insulinotropic polypeptide (GIP)] are central to postprandial glycemic control. Lipolysis is required for fat to slow gastric emptying and stimulate incretin release. OBJECTIVE: We aimed to determine the effect of pancreatic enzyme replacement therapy (PERT) on postprandial glycemia in adolescents with cystic fibrosis (CF). DESIGN: This was a double-blinded randomized crossover trial. Subjects consumed a high-fat pancake, with either PERT (50 000 IU lipase) or placebo. Gastric emptying was measured by a breath test and blood sampled frequently for plasma blood glucose, insulin, glucagon, GLP-1, and GIP. Data were also compared with seven healthy subjects. PARTICIPANTS: Fourteen adolescents (13.1 ± 2.7 y) with pancreatic-insufficient CF and seven healthy age-matched controls participated in the study. MAIN OUTCOME MEASURE: Postprandial hyperglycemia was measured as peak glucose and area under the curve for blood glucose at 240 minutes. RESULTS: CF subjects had postprandial hyperglycemia compared with controls (area under the curve, P < .0001). PERT reduced postprandial hyperglycemia (P = .0002), slowed gastric emptying (P = .003), and normalized GLP-1 and GIP secretion (P < .001 for each) when compared with placebo, without affecting insulin. CONCLUSION: In young people with pancreatic insufficient CF, PERT markedly attenuates postprandial hyperglycemia by slowing gastric emptying and augmenting incretin hormone secretion. | - |
dc.description.statementofresponsibility | Shiree J. Perano, Jennifer J. Couper, Michael Horowitz, A. James Martin, Stamatiki Kritas, Thomas Sullivan, and Chris K. Rayner | - |
dc.language.iso | en | - |
dc.publisher | Endocrine Society | - |
dc.rights | Copyright © 2014 by the Endocrine Society | - |
dc.source.uri | http://dx.doi.org/10.1210/jc.2013-4417 | - |
dc.subject | Humans | - |
dc.title | Pancreatic enzyme supplementation improves the incretin hormone response and attenuates postprandial glycemia in adolescents with cystic fibrosis: a randomized crossover trial | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1210/jc.2013-4417 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Couper, J. [0000-0003-4448-8629] | - |
dc.identifier.orcid | Horowitz, M. [0000-0002-0942-0306] | - |
dc.identifier.orcid | Martin, A. [0000-0002-1606-5461] | - |
dc.identifier.orcid | Rayner, C. [0000-0002-5527-256X] | - |
Appears in Collections: | Aurora harvest 2 Paediatrics publications |
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