{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:08:10Z","timestamp":1791205690575,"version":"4.1.0"},"reference-count":35,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:p>Controversy exists regarding the potential regenerative influences of incretin therapy on pancreatic \u03b2-cells versus possible adverse pancreatic proliferative effects. Examination of pancreata from age-matched organ donors with type 2 diabetes mellitus (DM) treated by incretin therapy (n = 8) or other therapy (n = 12) and nondiabetic control subjects (n = 14) reveals an \u223c40% increased pancreatic mass in DM treated with incretin therapy, with both increased exocrine cell proliferation (P &amp;lt; 0.0001) and dysplasia (increased pancreatic intraepithelial neoplasia, P &amp;lt; 0.01). Pancreata in DM treated with incretin therapy were notable for \u03b1-cell hyperplasia and glucagon-expressing microadenomas (3 of 8) and a neuroendocrine tumor. \u03b2-Cell mass was reduced by \u223c60% in those with DM, yet a sixfold increase was observed in incretin-treated subjects, although DM persisted. Endocrine cells costaining for insulin and glucagon were increased in DM compared with non-DM control subjects (P &amp;lt; 0.05) and markedly further increased by incretin therapy (P &amp;lt; 0.05). In conclusion, incretin therapy in humans resulted in a marked expansion of the exocrine and endocrine pancreatic compartments, the former being accompanied by increased proliferation and dysplasia and the latter by \u03b1-cell hyperplasia with the potential for evolution into neuroendocrine tumors.<\/jats:p>","DOI":"10.2337\/db12-1686","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T00:19:21Z","timestamp":1363997961000},"page":"2595-2604","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":370,"title":["Marked Expansion of Exocrine and Endocrine Pancreas With Incretin Therapy in Humans With Increased Exocrine Pancreas Dysplasia and the Potential for Glucagon-Producing Neuroendocrine Tumors"],"prefix":"10.2337","volume":"62","author":[{"given":"Alexandra E.","family":"Butler","sequence":"first","affiliation":[{"name":"Department of Medicine, David Geffen School of Medicine, University of 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