Capacity to secrete islet hormones after subtotal pancreatectomy for pancreatic cancer.
OBJECTIVE
To find out if the capacity to secrete insulin and glucagon was affected by pancreatectomy. Insulin and glucagon secretion was measured before and three months after subtotal pancreatectomy.


METHODS
Open study.


METHODS
University hospital.


METHODS
Five patients who each underwent removal of roughly 85% of the pancreas for cancer.


METHODS
Arginine 5 g given intravenously during glucose infusions that were varied in strength to give blood glucose concentrations of about 5, 15, and 28 mmol/l.


METHODS
Fasting concentrations of glucose, insulin, and glucagon; and effect of arginine on insulin and glucagon secretion at the different blood glucose concentrations.


RESULTS
Fasting concentrations of glucose in blood and insulin and glucagon in plasma were not significantly affected by the operation, but arginine-induced secretion of insulin and glucagon were severely impaired. The mean (SEM) insulin response to arginine was reduced from 316 (101) to 129 (29) pmol/l (p < 0.05) and when the patients were at the most hyperglycaemic from 1292 (316) to 474 (115) pmol/l (p < 0.05). The ratio of the change in response of insulin to blood glucose concentrations was also reduced (from 76.8 (25.9) to 27.9 (8.6) pmol/l/mmol/l) (p < 0.01). The plasma glucagon response to arginine was also reduced, by 40% at 5 and 15 mmol/l of glucose, and by 80% at 28 mmol/l glucose (p < 0.05).


CONCLUSIONS
Though diabetes does not usually develop after subtotal pancreatectomy, the capacity to secrete insulin and glucagon was considerably reduced.
Ahrén
B
B
Department of Surgery, Lund University, Sweden.
Andrén-Sandberg
A
A
D000368:Aged; D001120:Arginine / Q000494:pharmacology; D001786:Blood Glucose / Q000187:drug effects; D005934:Glucagon / Q000097:blood / Q000187:drug effects / Q000378:metabolism*; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011182:Postoperative Care
D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon; D001120:Arginine; D005947:Glucose