title: Improvement of glucose metabolism after a pancreatoduodenectomy.
abstract: OBJECTIVE
  The aim of this study was to investigate the mechanisms of the change in glucose metabolism after a pancreatoduodenectomy (PD).
  
  
  METHODS
  Oral glucose tolerance tests were performed in 17 patients before and 1 month after a PD. The changes in plasma glucose and insulin concentrations, homeostasis model of insulin resistance, and insulinogenic index (beta-cell function) were analyzed. Two additional factors, gastric emptying function and plasma glucagon-like peptide-1 (GLP-1) concentration, that possibly affect perioperative glucose metabolism were also assessed.
  
  
  RESULTS
  The plasma glucose and insulin concentrations were significantly lower after the operation, especially in preoperative diabetic patients. beta-Cell function did not change after the operation. On the other hand, insulin resistance became normal 1 month after the operation. The value of gastric emptying function after the operation was not statistically different in comparison with that before the operation. Postoperative plasma GLP-1 concentration was significantly higher than the preoperative value.
  
  
  CONCLUSIONS
  beta-Cell function is maintained after a PD, whereas the improvement of insulin resistance may cause a short-term transient improvement of the glucose metabolism after the operation. The significance of increased postoperative GLP-1 concentration remains an unsolved issue.
authors.affiliation: Department of Surgery, Saga University Faculty of Medicine, Saga, Japan. takao4412@hotmail.com
authors.forename: Takao
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Kenji
authors.initials: K
authors.lastname: Kitahara
authors.forename: Naohiko
authors.initials: N
authors.lastname: Kohya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyoshi
authors.forename: Kohji
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000378:metabolism / Q000601:surgery; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000378:metabolism; D004379:Duodenal Neoplasms / Q000150:complications / Q000378:metabolism / Q000601:surgery; D005260:Female; D005746:Gastric Emptying; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000378:metabolism / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin; D052216:Glucagon-Like Peptide 1; D005947:Glucose