The prevalence and impact of low faecal elastase-1 in community-based patients with type 2 diabetes

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dc.contributor.authorRiceman, M.D.
dc.contributor.authorBound, M.
dc.contributor.authorGrivell, J.
dc.contributor.authorHatzinikolas, S.
dc.contributor.authorPiotto, S.
dc.contributor.authorNguyen, N.Q.
dc.contributor.authorJones, K.L.
dc.contributor.authorHorowitz, M.
dc.contributor.authorRayner, C.K.
dc.contributor.authorPhillips, L.K.
dc.date.issued2019
dc.description.abstractAims: To determine the prevalence of low faecal elastase-1 (FE-1) (≤200 µg/g) in type 2 diabetes (T2DM), and to test the hypothesis that pancreatic enzyme replacement therapy (PERT) would reduce postprandial glycaemia after a high-fat, high-carbohydrate meal in T2DM subjects with low FE-1. Methods: Of 109 community-based patients who submitted stool samples, 10 had low FE-1 and 8 were recruited (6 male, 2 female, 67.8 ± 3.0 years). Participants were given a high-fat, high-carbohydrate meal (718 kcal) with either pancrelipase (50,000 units) or placebo in a randomised, double-blind, crossover fashion. The primary outcome was the difference in postprandial glycaemia following PERT vs placebo, as evaluated by the incremental area under the postprandial plasma glucose curve (iAUC). Secondary outcomes included differences in gastric half-emptying time (T50) measured using scintigraphy, and C-peptide iAUC. Results: The prevalence of low FE-1 in T2DM was 9.2% (95% CI 3.8–14.6%). There was no difference in postprandial glycaemia iAUC (P = 0.38), gastric emptying T50 (P = 0.69) or C-peptide iAUC (P = 0.25) after PERT compared to placebo. Conclusions: Decreased FE-1 has a relatively low prevalence in community-based patients with T2DM, and PERT does not reduce postprandial glycaemia in these patients. Clinical Trial Registration Number: ACTRN12617000349347.
dc.description.statementofresponsibilityMichael D. Riceman, Michelle Bound, Jacqueline Grivell, Seva Hatzinikolas, Samuel Piotto, Nam Q. Nguyen, Karen L. Jones, Michael Horowitz, Christopher K. Rayner, Liza K. Phillips
dc.identifier.citationDiabetes Research and Clinical Practice, 2019; 156:107822-1-107822-9
dc.identifier.doi10.1016/j.diabres.2019.107822
dc.identifier.issn0168-8227
dc.identifier.issn1872-8227
dc.identifier.orcidBound, M. [0000-0003-0211-5832]
dc.identifier.orcidNguyen, N.Q. [0000-0002-1270-5441]
dc.identifier.orcidJones, K.L. [0000-0002-1155-5816]
dc.identifier.orcidHorowitz, M. [0000-0002-0942-0306]
dc.identifier.orcidRayner, C.K. [0000-0002-5527-256X]
dc.identifier.orcidPhillips, L.K. [0000-0002-9066-717X]
dc.identifier.urihttps://hdl.handle.net/2440/145888
dc.language.isoen
dc.publisherElsevier
dc.rights© 2019 Elsevier B.V. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.diabres.2019.107822
dc.subjectType 2 diabetes mellitus; Fecal elastase-1; Exocrine pancreatic insufficiency; Pancrelipase; Postprandial glycemia; Gastric emptying
dc.subject.meshFeces
dc.subject.meshHumans
dc.subject.meshDiabetes Mellitus, Type 2
dc.subject.meshPancreatic Elastase
dc.subject.meshPrevalence
dc.subject.meshAged
dc.subject.meshFemale
dc.subject.meshMale
dc.titleThe prevalence and impact of low faecal elastase-1 in community-based patients with type 2 diabetes
dc.typeJournal article
pubs.publication-statusPublished

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