Does glucagon stimulation predict oral glucose tolerance in patients after simultaneous pancreas-kidney transplantation?
BACKGROUND
Exogenous glucagon rapidly stimulates insulin secretion. This test has been used to estimate insulin secretory capacity, which may predict oral glucose tolerance in patients after pancreas transplantation.


METHODS
In 32 pancreas-kidney transplant recipients, in 10 nondiabetic kidney transplant recipients, and in 9 healthy control subjects, a glucagon stimulation test (1 mg i.v.) and a 75-g oral glucose tolerance test were performed with determination of glucose, insulin, and C-peptide profiles.


RESULTS
Of 16 pancreas transplant recipients with the lowest insulin responses after glucagon, 7 had an impaired oral glucose tolerance, in contrast to 1 of 16 with high insulin responses (P=0.037). A low insulin response after glucagon was associated with significantly lower 120-min glucose concentrations (P=0.043) and a lower integrated incremental insulin response after oral glucose (P=0.006).


CONCLUSIONS
In pancreas-kidney transplant recipients, a low insulin response after intravenous glucagon predicts a reduced insulin response after oral glucose and an impaired oral glucose tolerance. This simple test may be helpful in the follow-up of pancreas transplant recipients.
Nauck
M A
MA
Department of Medicine, Ruhr-University Bochum, Knappschafts-Krankenhaus, Germany.
Pfeffer
F
F
Erb
M
M
Müller
T
T
Benz
S
S
Schmiegel
W
W
Hopt
U
U
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005934:Glucagon / Q000008:administration & dosage; D005951:Glucose Tolerance Test; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000187:drug effects / Q000378:metabolism; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology*
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon