Linked Life Data

20003758

Source:http://linkedlifedata.com/resource/pubmed/id/20003758

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2010-1-29
pubmed:databankReference
pubmed:abstractText
The initial success of islet transplantation (ITx) is followed by graft dysfunction (GDF) and insulin reintroduction. Exenatide, a GLP-1 agonist, increases insulin and decreases glucagon secretion and has potential for beta-cell regeneration. To improve functional islet mass, exenatide treatment was given to ITx recipients with GDF. The objective of this study was to assess metabolic and hormonal effects of exenatide in GDF. In this prospective, single-arm, nonrandomized study, 11 type 1 diabetes recipients of ITx with GDF had HbA1c, weight, insulin requirements, and 5-h mixed meal tolerance test (MMTT; with/without exenatide given before test) at baseline, 3, 6, and 12 months after initiating exenatide treatment. Baseline MMTT showed postprandial hyperglycemia and hyperglucagonemia. Daily exenatide treatment resulted in improved glucose, increased amylin/insulin ratio, and decreased proinsulin/insulin ratio as assessed by MMTT. Glucagon responses remained unchanged. Exenatide administration 1 h before MMTT showed decreased glucagon and glucose at 0 min and attenuation in their postprandial rise. Time-to-peak glucose was delayed, followed by insulin, proinsulin, amylin, and C-peptide, indicating glucose-driven insulin secretion. Five subjects completed 12-month follow-up. Glucose and glucagon suppression responses after MMTT with exenatide were no longer observed. Retrospective 3-month analysis of these subjects revealed higher and sustained glucagon levels that did not suppress as profoundly with exenatide administration, associated with higher glucose levels and increased C-peptide responses. In conclusion, Exenatide suppresses the abnormal postprandial hyperglucagonemia and hyperglycemia observed in GDF. Changes in amylin and proinsulin secretion may reflect more efficient insulin processing. Different degrees of responsiveness to exenatide were identified. These may help guide the clinical management of ITx recipients.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1555-3892
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
18
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1247-59
pubmed:dateRevised
2011-11-17
pubmed:meshHeading
pubmed-meshheading:20003758-Adult, pubmed-meshheading:20003758-Amyloid, pubmed-meshheading:20003758-Area Under Curve, pubmed-meshheading:20003758-C-Peptide, pubmed-meshheading:20003758-Demography, pubmed-meshheading:20003758-Diabetes Mellitus, Type 1, pubmed-meshheading:20003758-Female, pubmed-meshheading:20003758-Glucagon, pubmed-meshheading:20003758-Glucose, pubmed-meshheading:20003758-Humans, pubmed-meshheading:20003758-Hyperglycemia, pubmed-meshheading:20003758-Hypoglycemic Agents, pubmed-meshheading:20003758-Insulin, pubmed-meshheading:20003758-Islet Amyloid Polypeptide, pubmed-meshheading:20003758-Islets of Langerhans, pubmed-meshheading:20003758-Islets of Langerhans Transplantation, pubmed-meshheading:20003758-Male, pubmed-meshheading:20003758-Middle Aged, pubmed-meshheading:20003758-Peptides, pubmed-meshheading:20003758-Primary Graft Dysfunction, pubmed-meshheading:20003758-Prospective Studies, pubmed-meshheading:20003758-Transplantation, Homologous, pubmed-meshheading:20003758-Venoms
pubmed:year
2009
pubmed:articleTitle
Long-term metabolic and hormonal effects of exenatide on islet transplant recipients with allograft dysfunction.
pubmed:affiliation
Clinical Islet Transplant Program, Diabetes Research Institute, University of Miami Leonard M Miller School of Medicine, Miami, FL 33136, USA.
pubmed:publicationType
Journal Article, Controlled Clinical Trial, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural