Comment on: Butler et al. 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. Diabetes 2013;62:2595–2604

  1. Brett Lauring
  1. Merck Sharp & Dohme Corp., Whitehouse Station, New Jersey.
  1. Corresponding author: Samuel S. Engel, samuel_engel{at}

In the study by Butler et al. (1) in the July issue of Diabetes, we noted several issues in study design and data interpretation that substantially limit the ability to form conclusions from this small autopsy series. The study was designed with a nondiabetic control group (n = 14) that was age-, sex-, and BMI-matched to a group of 20 subjects with diabetes, 8 of whom had received incretin-based therapy and 12 of whom had not. However, the authors conducted a series of comparisons between the two subsets of subjects with diabetes who were not matched and who differed in important ways that were not adjusted for with respect to key characteristics. …

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