Alimentary hyperglycemia in patients with subtotal gastrectomy is associated with decreased insulin secretion but not with insulin resistance.
BACKGROUND
It is not clear whether alimentary hyperglycemia in gastrectomized patients is related with glucose tolerance or not.


METHODS
Glucose tolerance, insulin secretion, and peripheral insulin sensitivity were evaluated in 36 patients who underwent subtotal gastrectomy for gastric cancer using the oral glucose tolerance test (OGTT), the intravenous glucose tolerance test (IVGTT) and the euglycemic hyperinsulinemic glucose clamp technique (Glucose clamp).


RESULTS
Patients were categorized into three groups by OGTT; 8 cases were in group I (normal), 19 cases in group II (alimentary hyperglycemia), and 9 cases in group III (glucose intolerance). Both glucose disappearance rate (K value expressed as, %/min) and insulinogenic index as determined by IVGTT were significantly lower in groups II (1.00 +/- 0.24, 0.21 +/- 0.18, respectively) and III (0.90 +/- 0.13, 0.11 +/- 0.14, respectively), compared with group I (1.58 +/- 0.71, 0.35 +/- 0.18, respectively). Peripheral insulin sensitivity as measured by glucose clamp was not decreased in groups II and III.


CONCLUSIONS
These results suggest that in patients with alimentary hyperglycemia, glucose tolerance was impaired due to a decreased pancreatic sensitivity to blood glucose and not due to insulin resistance.
Yoshikawa
T
T
Yokohama City University, School of Medicine, First Department of Surgery, Yokohama, Japan.
Noguchi
Y
Y
Nomura
K
K
Fukuzawa
K
K
Makino
T
T
Tsuburaya
A
A
Imada
T
T
Matsumoto
A
A
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance / Q000175:diagnosis / Q000209:etiology*; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology*; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000175:diagnosis / Q000209:etiology*; D013274:Stomach Neoplasms / Q000601:surgery
D007328:Insulin