tailieunhanh - Báo cáo y học: "Exogenous glucagon-like peptide-1 attenuates the glycaemic response to postpyloric nutrient infusion in critically ill patients with type-2 diabetes"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Exogenous glucagon-like peptide-1 attenuates the glycaemic response to postpyloric nutrient infusion in critically ill patients with type-2 diabetes. | Deane et al. Critical Care 2011 15 R35 http content 15 1 R35 KS CRITICAL CARE RESEARCH Open Access Exogenous glucagon-like peptide-1 attenuates the glycaemic response to postpyloric nutrient infusion in critically ill patients with type-2 diabetes 2 2 Adam M Deane 1 Matthew J Summers Antony V Zaknic Marianne J Chapman 1 Robert JL Fraser Anna E Di Bartolomeo1 Judith M Wishart4 Michael Horowitz4 Abstract Introduction Glucagon-like peptide-1 GLP-1 attenuates the glycaemic response to small intestinal nutrient infusion in stress-induced hyperglycaemia and reduces fasting glucose concentrations in critically ill patients with type-2 diabetes. The objective of this study was to evaluate the effects of acute administration of GLP-1 on the glycaemic response to small intestinal nutrient infusion in critically ill patients with pre-existing type-2 diabetes. Methods Eleven critically ill mechanically-ventilated patients with known type-2 diabetes received intravenous infusions of GLP-1 pmol kg minute and placebo from t 0 to 270 minutes on separate days in randomised double-blind fashion. Between t 30 to 270 minutes a liquid nutrient was infused intraduodenally at a rate of 1 kcal min via a naso-enteric catheter. Blood glucose serum insulin and C-peptide and plasma glucagon were measured. Data are mean SEM. Results GLP-1 attenuated the overall glycaemic response to nutrient blood glucose AUC30-270 min GLP-1 2 244 184 vs. placebo 2 679 233 mmol l minute P . Blood glucose was maintained at 10 mmol l in 6 11 patients when receiving GLP-1 and 4 11 with placebo. GLP-1 increased serum insulin at 270 minutes GLP-1 vs. placebo mU l P but had no effect on the change in plasma glucagon. Conclusions Exogenous GLP-1 in a dose of pmol kg minute attenuates the glycaemic response to small intestinal nutrient in critically ill patients with type-2 diabetes. Given the modest magnitude of the reduction in glycaemia the effects .