ceruletide and Diabetes-Mellitus

Eleven healthy volunteers, five type I diabetics, and one type II diabetic man were examined. After an overnight fast caerulein (20 ng/kg) was injected intravenously and 60 min later an oral glucose tolerance test was performed with 100 g glucose in the normals and 25 g glucose in the diabetics. Blood pressure, pulse rate, blood glucose, serum insulin, glucagon, prolactin and growth hormone values were measured during the whole period of 240 min and compared with the same parameters in control tests in the same persons without caerulein application. None of the measured parameters were significantly influenced by caerulein. It is therefore concluded that in contrast to the stimulation of the exocrine pancreas functions of the endocrine pancreas, the pituitary gland and glucose tolerance are unchanged after caerulein.

Topics: Adult; Aged; Blood Glucose; Blood Pressure; Ceruletide; Diabetes Mellitus; Female; Glucagon; Growth Hormone; Heart Rate; Humans; Insulin; Male; Middle Aged; Prolactin

The clinical relevance of pancreatic exocrine insufficiency (PEI) in diabetic patients is unclear mostly because established function tests are invasive and expensive or lack sensitivity and specificity. A modified version of the noninvasive 13C-mixed triglyceride breath test (13C-MTGT) has recently been shown to detect moderate PEI reliably in patients with chronic pancreatitis. Its sensitivity and specificity in other patient groups are unknown. We therefore aimed to clarify the significance of this test for patients with diabetes mellitus (DM).. A secretin cerulein test and a modified 13C-MTGT were performed in 14 patients with DM (10 patients with type 1 DM) and 10 healthy volunteers.. Secretin cerulein test showed significantly lower outputs of amylase, trypsin, and lipase in DM compared with healthy volunteers (P < 0.05). Likewise, 13C-MTGT showed significantly lower maximal and cumulative 13C-exhalation in DM (P < 0.005). Stimulated lipase output correlated with cumulative 13C-exhalation (P < 0.05). However, when compared with normal values, only 2 patients with diabetes had abnormally low lipase output, whereas cumulative 13C-exhalation was pathologically decreased in 8 patients, including those with decreased lipase output.. The noninvasive 13C-MTGT can detect mild to moderate PEI in DM. However, the specificity of the 13C-MTGT is low in these patients probably because nonpancreatic mechanisms contribute to decreased intestinal lipolysis.

Topics: Adult; Aged; Breath Tests; Carbon Isotopes; Ceruletide; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Exocrine Pancreatic Insufficiency; Female; Humans; Male; Middle Aged; Pancreas, Exocrine; Pancreatic Function Tests; Quality of Life; Reproducibility of Results; Secretin; Sensitivity and Specificity; Surveys and Questionnaires; Triglycerides; Young Adult

Diabetes occurs in 20-30% of patients above forty years old with chronic pancreatitis (CP). The aim of the present study was to determine the relationship between development of diabetes mellitus in CP patients and insufficiency of pancreatic exocrine secretion as well as changes in composition of pancreatic juice. Ninety CP patients with diagnosis confirmed by endoscopic retrograde pancreatography (ERP) were studied. They were divided into 3 groups in dependency on ERP changes (according to Cambridge classification) and oral glucose tolerance test (OGTT): group A--equivocal or mild changes in ERP and normal OGTT (control group); group B--moderate or marked changes in ERP and normal OGTT: group C--moderate or marked changes in ERP and diabetes mellitus. The exocrine pancreatic function was determined by the secretin-caerulein test; volume of duodenal content and bicarbonate, protein, alpha-amylase activity outputs were measured.. All exocrine pancreatic function parameters were diminished in B and C groups compared with A group--differences were statistically significant. However in group C values of volume and bicarbonate, protein and amylase activity were especially low.. Exocrine pancreatic insufficiency is strongly associated with anatomical changes of the pancreas but also depends on endocrine function.

Topics: Adult; Aged; Ceruletide; Cholangiopancreatography, Endoscopic Retrograde; Chronic Disease; Diabetes Mellitus; Female; Glucose Tolerance Test; Humans; Male; Middle Aged; Pancreas; Pancreatitis; Secretin

Topics: Adult; Blood Glucose; Ceruletide; Diabetes Mellitus; Female; Humans; Insulin; Male