GLIDE
Research type
Research Study
Full title
A prospective observational study of acute pancreatitis severity and the association of glucose time in range and stress hyperglycaemia (detected with continuous glucose monitoring), plasma insulin depletion and bacterial endotoxaemia.
IRAS ID
361278
Contact name
Joe Geraghty
Contact email
Sponsor organisation
Manchester University NHS Foundation Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 7 months, 31 days
Research summary
Acute pancreatitis (AP) is associated with metabolic dysregulation including dysglycaemia which may predict poor clinical outcomes. Continuous glucose monitoring (CGM) offers a novel method for assessing glycaemia continuously in real time. The percentage of time spent in normal glucose range (TIR; 3.9-10.0 mmol/L) may correlate with key outcomes, including length of hospital stay (LOS), need for critical care, and mortality. This study aims to evaluate whether TIR measured via CGM can serve as a predictive marker in AP management. To do this, we will recruit 36 patients presenting with AP to Manchester Royal Infirmary and attach a CGM sensor subcutaneously on the arm or abdomen and match results to outcomes, especially length of stay and the clinical severity score.
Furthermore, while hyperglycaemia is frequently observed to accompany and contribute to severe AP, the underlying mechanism is not fully understood and is likely to be multifactorial, changing over the course of the disease. For example, in the acute phase of injury, the elevated adrenaline, cortisol and glucagon and inflammatory cytokine-induced insulin resistance contribute to hyperglycaemia. We propose that later in the course, the extent of collateral injury of pancreatic β-cells and consequent loss of insulin secretion may also impact disease severity. This loss of insulin secretion leads to the loss of insulin-mediated pancreatic antimicrobial secretion into the gut leading to gut dysbiosis, inflammation, reduced barrier function, bacterial translocation and infected pancreatic necrosis, resulting in severe AP. This suggests that plasma insulin depletion (with extensive hyperglycaemia) may represent early predictive biomarkers and elevated plasma bacterial endotoxin may represent a late biomarker for disease severity. To study this, we will measure plasma C-peptide (as a surrogate for insulin secretion) and bacterial endotoxin levels every fourth day and on discharge, or at day 28, whichever comes first and compare to clinical outcomes.REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
26/EM/0106
Date of REC Opinion
21 May 2026
REC opinion
Further Information Favourable Opinion