Pancreatic Enzyme Replacement and Glucose Regulation in Type 1 Diabetes
Status:
Not yet recruiting
Trial end date:
2024-02-01
Target enrollment:
Participant gender:
Summary
Recent studies have demonstrated reduced pancreatic volume is present within months of T1D
diagnosis in children, adolescents, and adults. As the pancreatic beta cells constitute only
1-2% of the pancreas, the degree of reduction in pancreas volume at disease onset suggests
exocrine involvement, challenging the established paradigm of T1D being solely a disease of
the endocrine pancreas.
To date there has not been an investigation of the potential for pancreatic enzyme
replacement therapy in the management of T1D. In individuals with cystic fibrosis-related
diabetes, enzyme replacement has been shown to reduce post-prandial glycemia excursions,
which are reflected in improved GLP-1 responses to mixed meal tolerance testing. As
post-prandial excursions and glucose variability are a significant challenge in T1D, how
enzyme replacement may impact these parameters is an important question.
The investigators hypothesize that patients with T1DM who have reduced pancreatic volume will
have improved glycemic responsiveness, reduced hypoglycemia, and improved symptoms of
pancreatic exocrine insufficiency when treated with pancreatic enzyme replacement (CREON).