title: Capacity to secrete islet hormones after subtotal pancreatectomy for pancreatic cancer.
abstract: 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.
authors.affiliation: Department of Surgery, Lund University, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Ahrén
authors.forename: A
authors.initials: A
authors.lastname: Andrén-Sandberg
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon; D001120:Arginine; D005947:Glucose