Pancreatectomy, Islet Cell Transplantation, and Nutrition Considerations

Narayanan, Siddharth; Bhutiani, Neal; Adamson, Dylan T.; Jones, Christopher M.

doi:10.1002/ncp.10578

Cited by 14 publications

(17 citation statements)

References 135 publications

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“…While nutrition aspects for patients with diabetes are defined [23], detailed nutritional evaluations and guidelines on the ill-effects of consuming free and added sugars still remain unexplored.…”

Section: Discussionmentioning

confidence: 99%

Sources of Free and Added Sugars and Their Nutritional Impact in Diabetic Patients

2022

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A high consumption of sugar leads to an increase in caloric intake, which in turn will lead to a higher risk of developing health issues. Foods contain both naturally occurring sugars and added sugars. The World Health Organization recommends that the daily intake of free sugars be below 10% of the total daily energy intake. Food performs a key role in maintaining an adequate glycaemic control in people with diabetes. However, there is a low compliance to dietary recommendations, namely in the amount of sugar intake. This review article aims to assess and compare the intake of various types of sugars in the general population and among individuals with and without a diabetes diagnosis, identify the food sources that contribute to the intake of free and added sugars, and understand their impact on health. Studies performed on the general population found that the consumption of sugar was high, and that children and teens are more likely to exceed the recommended amounts. It was found that diabetics consume less total and added sugar than non-diabetics, as well as a less sugary drinks. Guidelines and public health policy measures aimed at limiting the intake of free and added sugars are needed in order to minimize the consumption of foods high in empty calories.

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Section: Discussionmentioning

confidence: 99%

Sources of Free and Added Sugars and Their Nutritional Impact in Diabetic Patients

2022

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“…Population is aging worldwide, and the surgical needs of the elderly patients are increasing. The literature suggest that age itself might be an important risk factor for postoperative morbidity and mortality [25] as they faced multiple morbidities and geriatric syndromes and lower physiological reserve and preoperative nutritional conditioning than those of young patients [26][27][28][29]. Elderly patients benefit from a laparoscopic approach for many pathologies (cholecystectomy, hernia repairs, colorectal cancer resection, etc.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Pancreatoduodenectomy in Elderly Patients: A Systematic Review and Meta-Analysis

Bartoș

Mărgărit

Bocse

et al. 2022

Life

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Background and Aims: Recent single-center retrospective studies have focused on laparoscopic pancreatoduodenectomy (LPD) in elderly patients, and compared the outcomes between the laparoscopic and open approaches. Our study aimed to determine the outcomes of LPD in the elderly patients, by performing a systematic review and a meta-analysis of relevant studies. Methods: A comprehensive literature review was conducted utilizing the Embase, Medline, PubMed, Scopus and Cochrane databases to identify all studies that compared laparoscopic vs. open approach for pancreatoduodenectomy (PD). Results: Five retrospective studies were included in the final analysis. Overall, 90-day mortality rates were significantly decreased after LPD in elderly patients compared with open approaches (RR = 0.56; 95%CI: 0.32–0.96; p = 0.037, I2 = 0%). The laparoscopic approach had similar mortality rate at 30-day, readmission rate in hospital, Clavien–Dindo complications, pancreatic fistula grade B/C, complete resection rate, reoperation for complications and blood loss as the open approach. Additionally, comparing with younger patients (<70 years old), no significant differences were seen in elderly cohort patients regarding mortality rate at 90 days, readmission rate to hospital, and complication rate. Conclusions: Based on our meta-analysis, we identify that LPD in elderly is a safe procedure, with significantly lower 90-day mortality rates when compared with the open approach. Our results should be considered with caution, considering the retrospective analyses of the included studies; larger prospective studies are required.

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“…Inflammation and autoimmunity are one of the causes for the initiation of β-cell destruction during the development of T1D. Transplanted pancreatic islets themselves can also release pro-inflammatory cytokines, which play a significant role in cell failure and death, during and post-islet transplantation 43,44,46 . Thus, identifying factors that can help improve the preservation of pancreatic β-cell mass is in demand to improve islet transplant outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cholecystokinin Suppresses β-Cell Apoptosis, Including in Human Islets in a Transplant Model

Souza²,

Umhoefer³

et al. 2021

Preprint

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Loss of functional pancreatic β-cell mass and increased β-cell apoptosis are fundamental to the pathophysiology of both type 1 and type 2 diabetes. Pancreatic islet transplantation has the potential to cure type 1 diabetes but is often ineffective due to the death of the islet graft within the first few years after transplant. Therapeutic strategies to directly target pancreatic β-cell survival are needed to prevent and treat diabetes and to improve islet transplant outcomes. Reducing β-cell apoptosis is also a therapeutic strategy for type 2 diabetes. Cholecystokinin (CCK) is a peptide hormone typically produced in the gut after food intake, with positive effects on obesity and glucose metabolism in mouse models and human subjects. We have previously shown that pancreatic islets also produce CCK. The production of CCK within the islet promotes β-cell survival in rodent models of diabetes and aging. Now, we demonstrate a direct effect of CCK to reduce cytokine-mediated apoptosis in a β-cell line and in isolated mouse islets in a receptor-dependent manner. However, whether CCK can protect human β-cells was previously unknown. Here, we report that CCK can also reduce cytokine-mediated apoptosis in isolated human islets and CCK treatment in vivo decreases β-cell apoptosis in human islets transplanted into the kidney capsule of diabetic NOD/SCID mice. Collectively, these data identify CCK as a novel therapy that can directly promote β-cell survival in human islets and has therapeutic potential to preserve β-cell mass in diabetes and as an adjunct therapy after transplant.One Sentence SummaryCholecystokinin ameliorates pancreatic β-cell death under models of stress and after transplant of human islets.

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Pancreatectomy, Islet Cell Transplantation, and Nutrition Considerations

Cited by 14 publications

References 135 publications

Sources of Free and Added Sugars and Their Nutritional Impact in Diabetic Patients

Sources of Free and Added Sugars and Their Nutritional Impact in Diabetic Patients

Laparoscopic Pancreatoduodenectomy in Elderly Patients: A Systematic Review and Meta-Analysis

Cholecystokinin Suppresses β-Cell Apoptosis, Including in Human Islets in a Transplant Model

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