title: Glucagon-like peptide-1 receptor agonist exenatide has no acute effect on MRI-measured exocrine pancreatic function in patients with type 2 diabetes: a randomized trial.
abstract: OBJECTIVE
  To investigate the effect of infusion of the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide on exocrine pancreatic function.
  
  
  METHODS
  This was a randomized, placebo-controlled, double-blind, crossover study in 12 male patients with type 2 diabetes, treated with oral glucose-lowering agents. On two separate occasions, exenatide or placebo (saline 0.9%) were administered intravenously, in randomized order. Exocrine pancreatic function was measured using secretin-enhanced magnetic resonance cholangiopancreatography. The primary outcome measure was defined as secretin-stimulated pancreatic excretion volume. Secondary outcome measures were maximum secretion speed and the time to reach this maximum. In addition, changes in pancreatic duct (PD) diameter were measured.
  
  
  RESULTS
  Exenatide did not change secretin-stimulated pancreatic excretion volume, as compared with placebo (mean ± standard error of the mean 142.2 ± 15.6 ml vs 142.6 ± 8.5 ml, respectively; p = 0.590). Also, exenatide did not change the maximum secretion speed (33.1 ± 1.4 vs 36.9 ± 2.2; p = 0.221), nor the time to reach this maximum (both 4 min 30 s). No differences in PD diameter were observed between the two groups.
  
  
  CONCLUSIONS
  Infusion of exenatide did not directly influence MRI-measured exocrine pancreatic excretion in patients with type 2 diabetes. Although long-term studies are warranted, these findings suggest that potential adverse pancreatic effects of GLP-1 receptor agonists are not mediated by changes in exocrine pancreatic secretion.
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: Smits
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Tonneijck
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M H A
authors.initials: MH
authors.lastname: Muskiet
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M H H
authors.initials: MH
authors.lastname: Kramer
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Diamant
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: I C
authors.initials: IC
authors.lastname: Pieters-van den Bos
authors.affiliation: Diabetes Centre, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: D H
authors.initials: DH
authors.lastname: van Raalte
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: D L
authors.initials: DL
authors.lastname: Cahen
mesh_terms: D000328:Adult; D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D000077270:Exenatide; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000187:drug effects*; D010183:Pancreatic Ducts / Q000473:pathology; D010455:Peptides / Q000494:pharmacology*; D012633:Secretin / Q000378:metabolism; D014688:Venoms / Q000494:pharmacology*; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D012633:Secretin; D000077270:Exenatide; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: exenatide; exocrine pancreatic function; glucagon-like peptide-1 receptor agonists; pancreatitis; type 2 diabetes