Kathleen M Dungan1, Phil A Hart2, Dana K Andersen3, Marina Basina4, Vernon M Chinchilli5, Kirstie K Danielson6, Carmella Evans-Molina7, Mark O Goodarzi8, Carla J Greenbaum9, Rita R Kalyani10, Maren R Laughlin3, Ariana Pichardo-Lowden11, Richard E Pratley12, Jose Serrano3, Emily K Sims7, Cate Speake9, Dhiraj Yadav13, Melena D Bellin, Frederico G S Toledo14. 1. From the Divisions of Endocrinology, Diabetes and Metabolism. 2. Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH. 3. Division of Digestive Diseases and Nutrition, National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD. 4. Division of Endocrinology, Gerontology and Metabolism, Stanford University School of Medicine, Stanford, CA. 5. Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA. 6. Division of Endocrinology, Diabetes and Metabolism, University of Illinois, Chicago, IL. 7. Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine; Indianapolis, IN. 8. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA. 9. Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA. 10. Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD. 11. Division of Endocrinology, Diabetes and Metabolism, Penn State Health, Penn State College of Medicine, Hershey, PA. 12. AdventHealth Translational Research Institute, Orlando, FL. 13. Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA. 14. Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVES: The metabolic abnormalities that lead to diabetes mellitus (DM) after an episode of acute pancreatitis (AP) have not been extensively studied. This article describes the objectives, hypotheses, and methods of mechanistic studies of glucose metabolism that comprise secondary outcomes of the DREAM (Diabetes RElated to Acute pancreatitis and its Mechanisms) Study. METHODS: Three months after an index episode of AP, participants without preexisting DM will undergo baseline testing with an oral glucose tolerance test. Participants will be followed longitudinally in three subcohorts with distinct metabolic tests. In the first and largest subcohort, oral glucose tolerance tests will be repeated 12 months after AP and annually to assess changes in β-cell function, insulin secretion, and insulin sensitivity. In the second, mixed meal tolerance tests will be performed at 3 and 12 months, then annually, and following incident DM to assess incretin and pancreatic polypeptide responses. In the third, frequently sampled intravenous glucose tolerance tests will be performed at 3 months and 12 months to assess the first-phase insulin response and more precisely measure β-cell function and insulin sensitivity. CONCLUSIONS: The DREAM study will comprehensively assess the metabolic and endocrine changes that precede and lead to the development of DM after AP.
OBJECTIVES: The metabolic abnormalities that lead to diabetes mellitus (DM) after an episode of acute pancreatitis (AP) have not been extensively studied. This article describes the objectives, hypotheses, and methods of mechanistic studies of glucose metabolism that comprise secondary outcomes of the DREAM (Diabetes RElated to Acute pancreatitis and its Mechanisms) Study. METHODS: Three months after an index episode of AP, participants without preexisting DM will undergo baseline testing with an oral glucose tolerance test. Participants will be followed longitudinally in three subcohorts with distinct metabolic tests. In the first and largest subcohort, oral glucose tolerance tests will be repeated 12 months after AP and annually to assess changes in β-cell function, insulin secretion, and insulin sensitivity. In the second, mixed meal tolerance tests will be performed at 3 and 12 months, then annually, and following incident DM to assess incretin and pancreatic polypeptide responses. In the third, frequently sampled intravenous glucose tolerance tests will be performed at 3 months and 12 months to assess the first-phase insulin response and more precisely measure β-cell function and insulin sensitivity. CONCLUSIONS: The DREAM study will comprehensively assess the metabolic and endocrine changes that precede and lead to the development of DM after AP.
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Authors: Phil A Hart; Georgios I Papachristou; Walter G Park; Anne-Marie Dyer; Vernon M Chinchilli; Elham Afghani; Venkata S Akshintala; Dana K Andersen; James L Buxbaum; Darwin L Conwell; Kathleen M Dungan; Jeffrey J Easler; Evan L Fogel; Carla J Greenbaum; Rita R Kalyani; Murray Korc; Richard Kozarek; Maren R Laughlin; Peter J Lee; Jennifer L Maranki; Stephen J Pandol; Anna Evans Phillips; Jose Serrano; Vikesh K Singh; Cate Speake; Temel Tirkes; Frederico G S Toledo; Guru Trikudanathan; Santhi Swaroop Vege; Ming Wang; Cemal Yazici; Atif Zaheer; Christopher E Forsmark; Melena D Bellin; Dhiraj Yadav Journal: Pancreas Date: 2022-07-01 Impact factor: 3.243
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