{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:54:56Z","timestamp":1793040896575,"version":"4.5.0"},"reference-count":27,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,2]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The aim of this study was to assess whether exendin-(9-39) will increase fasting and postprandial plasma glucose and decrease the incidence of hypoglycemia in children with hyperinsulinism (HI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This was an open-label, four-period crossover study. In periods 1 and 2, the effect of three different dosing regimens of exendin-(9-39) (group 1, 0.28 mg\/kg; group 2, 0.44 mg\/kg; group 3, 0.6 mg\/kg) versus vehicle on fasting glucose was assessed in 16 children with HI. In periods 3 and 4, a subset of eight subjects received either vehicle or exendin-(9-39) (0.6 mg\/kg) during a mixed-meal tolerance test (MMTT) and an oral protein tolerance test (OPTT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Treatment group 2 showed 20% (P = 0.037) increase in the area under the curve (AUC) of fasting glucose. A significant increase in AUC of glucose was also observed during the MMTT and OPTT; treatment with exendin-(9-39) resulted in 28% (P \u2264 0.001) and 30% (P = 0.01) increase in AUC of glucose, respectively. Fasting AUC of insulin decreased by 57% (P = 0.009) in group 3. In contrast, AUC of insulin was unchanged during the MMTT and almost twofold higher (P = 0.004) during the OPTT with exendin-(9-39) treatment. In comparison with vehicle, infusion of exendin-(9-39) resulted in significant reduction in likelihood of hypoglycemia in group 2, by 76% (P = 0.009), and in group 3, by 84% (P = 0.014). Administration of exendin-(9-39) during the OPTT resulted in 82% (P = 0.007) reduction in the likelihood of hypoglycemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>These results support a therapeutic potential of exendin-(9-39) to prevent fasting and protein-induced hypoglycemia in children with HI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-2009","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T10:56:22Z","timestamp":1649847382000},"page":"1381-1390","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":11,"title":["Exendin-(9-39) Effects on Glucose and Insulin in Children With Congenital Hyperinsulinism During Fasting and During a Meal and a Protein Challenge"],"prefix":"10.2337","volume":"45","author":[{"given":"Darko","family":"Stefanovski","sequence":"first","affiliation":[{"name":"1School of Veterinarian Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Vajravelu","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology and Diabetes, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA"},{"name":"3Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Givler","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology and Diabetes, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1225-8087","authenticated-orcid":false,"given":"Diva D.","family":"De Le\u00f3n","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology and Diabetes, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA"},{"name":"3Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"2023053114511661900_B1","doi-asserted-by":"crossref","first-page":"E355","DOI":"10.1210\/jc.2012-2169","article-title":"Genotype and phenotype correlations in 417 children with congenital hyperinsulinism","volume":"98","author":"Snider","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"2023053114511661900_B2","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1210\/jc.2015-3651","article-title":"Perspective on the genetics and diagnosis of congenital hyperinsulinism disorders","volume":"101","author":"Stanley","year":"2016","journal-title":"J Clin 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