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Effect of Pramlintide on Postprandial Glucose Fluxes in Type 1 Diabetes

Hinshaw, Ling ; Schiavon, Michele ; Dadlani, Vikash ; Mallad, Ashwini ; Dalla Man, Chiara ; Bharucha, Adil ; Basu, Rita ; Geske, Jennifer R ; Carter, Rickey E ; Cobelli, Claudio ; Basu, Ananda ; Kudva, Yogish C

The journal of clinical endocrinology and metabolism, 2016-05, Vol.101 (5), p.1954-1962 [Periódico revisado por pares]

United States: Endocrine Society

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  • Título:
    Effect of Pramlintide on Postprandial Glucose Fluxes in Type 1 Diabetes
  • Autor: Hinshaw, Ling ; Schiavon, Michele ; Dadlani, Vikash ; Mallad, Ashwini ; Dalla Man, Chiara ; Bharucha, Adil ; Basu, Rita ; Geske, Jennifer R ; Carter, Rickey E ; Cobelli, Claudio ; Basu, Ananda ; Kudva, Yogish C
  • Assuntos: Adult ; Aged ; Blood Glucose - metabolism ; Cross-Over Studies ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - drug therapy ; Female ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin Resistance - physiology ; Islet Amyloid Polypeptide - therapeutic use ; Male ; Middle Aged ; Original ; Postprandial Period - drug effects ; Treatment Outcome ; Young Adult
  • É parte de: The journal of clinical endocrinology and metabolism, 2016-05, Vol.101 (5), p.1954-1962
  • Notas: The work was supported by National Institutes of Health (NIH) Grants DK R01 085516 and DK DP3 094331 and Grant UL1 TR000135 from the National Center for Advancing Translational Science, a component of the NIH. C.D.M. and C.C. are partially funded by Italian Ministero dell'Istruzione, dell'Università e della Ricerca (Progetto FIRB 2009).
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  • Descrição: Context: Early postprandial hyperglycemia and delayed hypoglycemia remain major problems in current management of type 1 diabetes (T1D). Objective: Our objective was to investigate the effects of pramlintide, known to suppress glucagon and delay gastric emptying, on postprandial glucose fluxes in T1D. Design: This was a single-center, inpatient, randomized, crossover study. Patients: Twelve patients with T1D who completed the study were analyzed. Interventions: Subjects were studied on two occasions with or without pramlintide. Triple tracer mixed-meal method and oral minimal model were used to estimate postprandial glucose turnover and insulin sensitivity (SI). Integrated liver insulin sensitivity was calculated based on glucose turnover. Plasma glucagon and insulin were measured. Main Outcome Measure: Glucose turnover and SI were the main outcome measures. Results: With pramlintide, 2-hour postprandial glucose, insulin, glucagon, glucose turnover, and SI indices showed: plasma glucose excursions were reduced (difference in incremental area under the curve [iAUC], 444.0 mMmin, P = .0003); plasma insulin concentrations were lower (difference in iAUC, 7642.0 pMmin; P = .0099); plasma glucagon excursions were lower (difference in iAUC, 1730.6 pg/mlmin; P = .0147); meal rate of glucose appearance was lower (difference in iAUC: 1196.2 μM/kg fat free mass [FFM]; P = .0316), endogenous glucose production was not different (difference in iAUC: −105.5 μM/kg FFM; P = .5842), rate of glucose disappearance was lower (difference in iAUC: 1494.2 μM/kg FFM; P = .0083). SI and liver insulin sensitivity were not different between study visits (P > .05). Conclusions: Inhibition of glucagon and gastric emptying delaying reduced 2-hour prandial glucose excursions in T1D by delaying meal rate of glucose appearance. We investigated the effects of pramlintide on postprandial glucose fluxes in T1D. Pramlintide reduced 2-hour prandial glucose excursions in T1D by delaying meal rate of glucose appearance.
  • Editor: United States: Endocrine Society
  • Idioma: Inglês
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