Pancreatic enzyme supplementation improves the incretin hormone response and attenuates postprandial glycaemia in adolescents with cystic fibrosis: a randomized crossover trial.
Study design (if review, criteria of inclusion for studies)
double blinded randomised crossover trial.
Participants
14 adolescents (13.1 +/- 2.7 years) with pancreatic insufficient CF and 7 healthy age matched controls.
Interventions
Subjects consumed a high fat pancake, with either PERT (50,000IU lipase) or placebo.
Outcome measures
Post prandial hyperglycaemia measured as peak glucose and area under the curve for blood glucose at 240 minutes.
Main results
CF subjects had postprandial hyperglycaemia compared to controls (area under the curve, P < 0.0001). PERT reduced postprandial hyperglycaemia (P = 0.0002), slowed gastric emptying (P = 0.003), and normalised GLP-1 and GIP secretion (P <0.001 for each) when compared to placebo, without affecting insulin.
Authors' conclusions
In young people with pancreatic insufficient CF, PERT markedly attenuates postprandial hyperglycaemia by slowing gastric emptying and augmenting incretin hormone secretion.