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261 results on '"Eppel, W."'

14. Glucagon-like peptide 1 (GLP-1) drives postprandial hyperinsulinemic hypoglycemia in pregnant women with a history of roux-en-Y gastric bypass operation

Author

Leutner, M., Klimek, P., Göbl, C., Bozkurt, L., Harreiter, J., Husslein, P., Eppel, W., Baumgartner-Parzer, S., Pacini, G., Thurner, S., Kautzky-Willer, A., Leutner, M., Klimek, P., Göbl, C., Bozkurt, L., Harreiter, J., Husslein, P., Eppel, W., Baumgartner-Parzer, S., Pacini, G., Thurner, S., and Kautzky-Willer, A.

Abstract

BACKGROUND: The influential role of incretin hormones on glucose metabolism in patients with a history of Roux-en-Y gastric bypass (RYGB) has been investigated thoroughly, but there has been little examination of the effect of incretins and ectopic lipids on altered glucose profiles, especially severe hypoglycemia in pregnant women with RYGB. METHODS: In this prospective clinical study, an oral glucose tolerance test (OGTT), an intravenous glucose tolerance test (IVGTT), and continuous glucose monitoring (CGM) were conducted in 25 women with RYGB during pregnancy, 19 of normal weight (NW) and 19 with obesity (OB) between the 24th and the 28th weeks of pregnancy, and 3 to 6 months post-partum. Post-partum, the ectopic lipid content in the liver, heart, and skeletal muscle was analyzed using 1H-magnetic resonance spectroscopy (1H-MRS). RESULTS: RYGB patients presented with major fluctuations in glucose profiles, including a high occurrence of postprandial hyperglycemic spikes and hypoglycemic events during the day, as well as a high risk of hypoglycemic periods during the night (2.9 ± 1.1% vs. 0.1 ± 0.2% in the OB and vs. 0.8 ± 0.6% in the NW groups, p < 0.001). During the extended OGTT, RYGB patients presented with exaggerated expression of GLP-1, which was the main driver of the exaggerated risk of postprandial hypoglycemia in a time-lagged correlation analysis. Basal and dynamic GLP-1 levels were not related to insulin sensitivity, insulin secretion, or beta cell function and did not differ between pregnant women with and without GDM. A lower amount of liver fat (2.34 ± 5.22% vs.5.68 ± 4.42%, p = 0.015), which was positively related to insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR: rho = 0.61, p = 0.002) and beta-cell function (insulinogenic index: rho = 0.65, p = 0.001), was observed in the RYGB group after delivery in comparison to the OB group. CONCLUSION: GLP-1 is mainly involved in the regulation of postprandial glucose metabo

Published
2018

22. Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: study protocol for an international, prospective, multicentre cohort trial

Author

Huhn, E A, Fischer, T, Göbl, C S, Todesco Bernasconi, M, Kreft, M, Kunze, M, Schoetzau, A, Dölzlmüller, E, Eppel, W, Husslein, P, Ochsenbein-Koelble, N, Zimmermann, R, Bäz, E, Prömpeler, H, Bruder, E, Hahn, S, Hoesli, I, Huhn, E A, Fischer, T, Göbl, C S, Todesco Bernasconi, M, Kreft, M, Kunze, M, Schoetzau, A, Dölzlmüller, E, Eppel, W, Husslein, P, Ochsenbein-Koelble, N, Zimmermann, R, Bäz, E, Prömpeler, H, Bruder, E, Hahn, S, and Hoesli, I

Abstract

INTRODUCTION: As the accurate diagnosis and treatment of gestational diabetes mellitus (GDM) is of increasing importance; new diagnostic approaches for the assessment of GDM in early pregnancy were recently suggested. We evaluate the diagnostic power of an 'early' oral glucose tolerance test (OGTT) 75 g and glycosylated fibronectin (glyFn) for GDM screening in a normal cohort. METHODS AND ANALYSIS: In a prospective cohort study, 748 singleton pregnancies are recruited in 6 centres in Switzerland, Austria and Germany. Women are screened for pre-existing diabetes mellitus and GDM by an 'early' OGTT 75 g and/or the new biomarker, glyFn, at 12-15 weeks of gestation. Different screening strategies are compared to evaluate the impact on detection of GDM by an OGTT 75 g at 24-28 weeks of gestation as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A new screening algorithm is created by using multivariable risk estimation based on 'early' OGTT 75 g and/or glyFn results, incorporating maternal risk factors. Recruitment began in May 2014. ETHICS AND DISSEMINATION: This study received ethical approval from the ethics committees in Basel, Zurich, Vienna, Salzburg and Freiburg. It was registered under http://www.ClinicalTrials.gov (NCT02035059) on 12 January 2014. Data will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02035059.

Published
2016

23. Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: study protocol for an international, prospective, multicentre cohort trial

Author

Huhn, E A, primary, Fischer, T, additional, Göbl, C S, additional, Todesco Bernasconi, M, additional, Kreft, M, additional, Kunze, M, additional, Schoetzau, A, additional, Dölzlmüller, E, additional, Eppel, W, additional, Husslein, P, additional, Ochsenbein-Koelble, N, additional, Zimmermann, R, additional, Bäz, E, additional, Prömpeler, H, additional, Bruder, E, additional, Hahn, S, additional, and Hoesli, I, additional

Published
2016
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41. Ein Fall von Patau-Syndrom

Author

Küffer, Elisabeth, primary, Asseryanis, Ella, additional, Eppel, W., additional, Schurz, Brigitte, additional, and Reinold, E., additional

Published
2008
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