PMID- 28911142
OWN - NLM
STAT- MEDLINE
DCOM- 20171012
LR  - 20181208
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 102
IP  - 9
DP  - 2017 Sep 1
TI  - Deficient Endogenous Glucose Production During Exercise After Total 
      Pancreatectomy/Islet Autotransplantation.
PG  - 3288-3295
LID - 10.1210/jc.2017-00923 [doi]
AB  - CONTEXT: Total pancreatectomy followed by intrahepatic islet autotransplantation 
      (TP/IAT) is performed to alleviate severe, unrelenting abdominal pain caused by 
      chronic pancreatitis, to improve quality of life, and to prevent diabetes. 
      OBJECTIVE: To determine the cause of exercise-induced hypoglycemia that is a 
      common complaint in TP/IAT recipients. DESIGN: Participants completed 1 hour of 
      steady-state exercise. SETTING: Hospital research unit. PATIENTS AND OTHER 
      PARTICIPANTS: We studied 14 TP/IAT recipients and 10 age- and body mass 
      index-matched control subjects. INTERVENTIONS: Peak oxygen uptake (VO2) was 
      determined via a symptom-limited maximal cycle ergometer test. Fasted subjects 
      then returned for a primed [6,6-2H2]-glucose infusion to measure endogenous 
      glucose production while completing 1 hour of bicycle exercise at either 40% or 
      70% peak VO2. MAIN OUTCOME MEASURES: Blood samples were obtained to measure 
      glucose metabolism and counterregulatory hormones before, during, and after 
      exercise. RESULTS: Although the Borg Rating of Perceived Exertion did not differ 
      between recipients and control subjects, aerobic capacity was significantly 
      higher in controls than in recipients (40.4 +/- 2.0 vs 27.2 +/- 1.4 mL/kg per minute; 
      P < 0.001). This difference resulted in workload differences between control 
      subjects and recipients to reach steady-state exercise at 40% peak VO2 (P = 
      0.003). Control subjects significantly increased their endogenous glucose 
      production from 12.0 +/- 1.0 to 15.2 +/- 1.0 micromol/kg per minute during moderate 
      exercise (P = 0.01). Recipients did not increase endogenous glucose production 
      during moderate exercise (40% peak VO2) but succeeded during heavy exercise, from 
      10.1 +/- 0.4 to 14.8 +/- 2.0 micromol/kg per minute (70% peak VO2; P = 0.001). 
      CONCLUSIONS: Failure to increase endogenous glucose production during moderate 
      exercise may be a key contributor to the hypoglycemia TP/IAT recipients 
      experience.
CI  - Copyright (c) 2017 Endocrine Society
FAU - Bogachus, Lindsey D
AU  - Bogachus LD
AD  - Pacific Northwest Diabetes Research Institute, Seattle, Washington 98122.
AD  - Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, 
      University of Washington, Seattle, Washington 98195.
FAU - Oseid, Elizabeth
AU  - Oseid E
AD  - Pacific Northwest Diabetes Research Institute, Seattle, Washington 98122.
FAU - Bellin, Melena
AU  - Bellin M
AD  - Division of Diabetes, Endocrinology, and Metabolism, Department of Medicines and 
      Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455.
FAU - Vella, Adrian
AU  - Vella A
AD  - Division of Endocrinology, Diabetes, and Metabolism, Mayo Clinic College of 
      Medicine, Rochester, Minnesota 55905.
FAU - Robertson, R Paul
AU  - Robertson RP
AD  - Pacific Northwest Diabetes Research Institute, Seattle, Washington 98122.
AD  - Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, 
      University of Washington, Seattle, Washington 98195.
AD  - Division of Diabetes, Endocrinology, and Metabolism, Department of Medicines and 
      Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455.
LA  - eng
GR  - R01 DK078646/DK/NIDDK NIH HHS/United States
GR  - TL1 TR000422/TR/NCATS NIH HHS/United States
GR  - KL2 TR002317/TR/NCATS NIH HHS/United States
GR  - KL2 TR000421/TR/NCATS NIH HHS/United States
GR  - UL1 TR000423/TR/NCATS NIH HHS/United States
GR  - T32 DK007203/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Blood Glucose)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Adult
MH  - Blood Glucose/analysis
MH  - Case-Control Studies
MH  - Exercise/*physiology
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Glucose/*metabolism
MH  - Heart Rate/physiology
MH  - Humans
MH  - Islets of Langerhans Transplantation/*methods
MH  - Male
MH  - Oxygen Consumption/physiology
MH  - Pancreatectomy/*methods
MH  - Pancreatitis, Chronic/diagnosis/*surgery
MH  - Risk Assessment
MH  - Sampling Studies
PMC - PMC5587075
EDAT- 2017/09/16 06:00
MHDA- 2017/10/13 06:00
PMCR- 2018/09/01
CRDT- 2017/09/16 06:00
PHST- 2017/04/18 00:00 [received]
PHST- 2017/06/06 00:00 [accepted]
PHST- 2017/09/16 06:00 [entrez]
PHST- 2017/09/16 06:00 [pubmed]
PHST- 2017/10/13 06:00 [medline]
PHST- 2018/09/01 00:00 [pmc-release]
AID - 3920533 [pii]
AID - jcem_201700923 [pii]
AID - 10.1210/jc.2017-00923 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2017 Sep 1;102(9):3288-3295. doi: 10.1210/jc.2017-00923.