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Coronavirus disease 2019 (COVID-19) results from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical features and subsequent medical treatment, combined with the impact of a global pandemic, require specific nutritional therapy in hospitalised adults. This document aims to provide Australian and New Zealand clinicians with guidance on managing critically and acutely unwell adult patients hospitalised with COVID-19. These recommendations were developed using expert

MS.Relationship between pancreatic hormones and glucose metabolism: A cross-sectional study in patients after acute pancreatitis. Am J Physiol Gastrointest Liver Physiol 311: G50 -G58, 2016. First published May 12, 2016 doi:10.1152/ajpgi.00074.2016.-Abnormal glucose metabolism is present in almost 40% of patients after acute pancreatitis, but its pathophysiology has been poorly investigated. Pancreatic hormone derangements have been sparingly studied to date, and their relationship with abnormal glucose metabolism is largely unknown. The aim was to investigate the associations between pancreatic hormones and glucose metabolism after acute pancreatitis, including the effect of potential confounders. This was a cross-sectional study of 83 adult patients after acute pancreatitis. Fasting venous blood was collected from all patients and used for analysis of insulin, glucagon, pancreatic polypeptide, amylin, somatostatin, C-peptide, glucose, and hemoglobin A1c. Statistical analyses were conducted using the modified Poisson regression, multivariable linear regression, and Spearman's correlation. Age, sex, body mass index, recurrence of acute pancreatitis, duration from first attack, severity, and etiology were adjusted for. Increased insulin was significantly associated with abnormal glucose metabolism after acute pancreatitis, in both unadjusted (P ϭ 0.038) and adjusted (P ϭ 0.001) analyses. Patients with abnormal glucose metabolism also had significantly decreased pancreatic polypeptide (P ϭ 0.001) and increased amylin (P ϭ 0.047) in adjusted analyses. Somatostatin, C-peptide, and glucagon were not changed significantly in both unadjusted and adjusted analyses. Increased insulin resistance and reduced insulin clearance may be important components of hyperinsulinemic compensation in patients after acute pancreatitis. Increased amylin and reduced pancreatic polypeptide fasting levels characterize impaired glucose homeostasis. Clinical studies investigating islet-cell hormonal responses to mixed-nutrient meal testing and euglycemichyperinsulinemic clamps are now warranted for further insights into the role of pancreatic hormones in glucose metabolism derangements secondary to pancreatic diseases. acute pancreatitis; glucose metabolism; insulin; amylin; pancreatic polypeptide THE PANCREAS, A DUAL GLAND with both endocrine and exocrine functions, plays a key role in the development of both diabetes and pancreatitis. Diabetes mellitus (DM) is one of the most prevalent chronic diseases and contributes significantly to allcause worldwide mortality, with one in 12 adult deaths attributed to it (15a, 16). Acute pancreatitis (AP) is the most common cause of gastrointestinal-related hospitalizations in the Western countries, with over 270,000 patients requiring hospitalization each year in the United States alone (19). A recent comprehensive systematic review and meta-analysis of prospective clinical studies (11) showed that abnormal glucose metabolism (AGM) after an episode of AP is present in nearly 40% of patients without h...

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