Incretin hormones and beta cell function in chronic pancreatitis.

摘要: Type 2 diabetes mellitus (T2DM) has been shown to be characterised by an almost abolished incretin effect. The effect refers the phenomenon of oral glucose eliciting a higher insulin response than intravenous at identical plasma profiles. It is conveyed two insulinotropic hormones: glucagon-like peptide-1 (GLP-1) and glucose-dependent polypeptide (GIP). GLP-1 GIP are secreted from small intestines in ingestion nutrients. defect T2DM virtually lost GIP. unknown whether primary event leading or arises as consequence diabetic state. To investigate this we studied patients with chronic pancreatitis (CP). Over time, CP leads secondary (DM). If DM exhibit characteristic type deficiencies normal tolerance that regard, it more likely these consequences state rather events T2DM. On other hand, if physiology preserved independently endocrine status CP, could represent pathogenetic defect. Three protocols have employed this. In study investigating postprandial responses 8 exocrine pancreatic insufficiency, without enzyme supplementation (PES), observed compared matched healthy subjects; and, further, PES increased patients. This suggests not only secretion hormones regulated mere presence nutrients intestine, but also assimilation such involved, well. Furthermore, gauged DM. Eight subjects were for comparison. was tolerant whereas strongly reduced DM, suggesting Lastly, investigated impaired GIP, most occurs conclusion, suggest that: 1) among CP; 2) stimulates GLP-1; 3) deteriorating homeostasis,