Study design (if review, criteria of inclusion for studies)
Double-blind randomized crossover trial.
Six participants with CF and IGT were studied on 2 days.
After overnight fasting, patients received exenatide 2.5 mcg or placebo (0.9% saline) subcutaneously 15 minutes before a pancake meal labelled with (13) C octanoate and pancreatic enzyme replacement.
Primary outcomes: area under the curve over 240 minutes (AUC 240 ) for blood glucose and peak blood glucose. Secondary outcomes: AUC240 for insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)
The primary outcomes, area under the curve over 240 minutes (AUC 240 ) for blood glucose (P < 0.0001) and peak blood glucose (7.65 mM +/- 0.34 [mean +/- SE] vs 9.53 mM +/- 0.63, P < 0.0001), were markedly lower after exenatide than placebo. AUC240 for insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) was also lower after exenatide. Gastric emptying was markedly slower after exenatide, as assessed by time for 10% gastric emptying and peak (13) CO2 excretion.
Exenatide corrects postprandial hyperglycaemia in young people with CF and IGT. GLP-1 agonists are a candidate treatment in CF-related diabetes.