Impaired glucose-induced glucagon suppression after partial pancreatectomy

Research output: Contribution to journalJournal articleResearchpeer-review

Henning Schrader, Bjoern A Menge, Thomas G K Breuer, Peter R Ritter, Waldemar Uhl, Wolfgang E Schmidt, Jens J Holst, Juris J Meier

INTRODUCTION: The glucose-induced decline in glucagon levels is often lost in patients with type 2 diabetes. It is unclear whether this is due to an independent defect in alpha-cell function or secondary to the impairment in insulin secretion. We examined whether a partial pancreatectomy in humans would also impair postchallenge glucagon concentrations and, if so, whether this could be attributed to the reduction in insulin levels. PATIENTS AND METHODS: Thirty-six patients with pancreatic tumours or chronic pancreatitis were studied before and after approximately 50% pancreatectomy with a 240-min oral glucose challenge, and the plasma concentrations of glucose, insulin, C-peptide, and glucagon were determined. RESULTS: Fasting and postchallenge insulin and C-peptide levels were significantly lower after partial pancreatectomy (P < 0.0001). Likewise, fasting glucagon concentrations tended to be lower after the intervention (P = 0.11). Oral glucose ingestion elicited a decline in glucagon concentrations before surgery (P < 0.0001), but this was lost after partial pancreatectomy (P < 0.01 vs. preoperative values). The loss of glucose-induced glucagon suppression was found after both pancreatic head (P < 0.001) and tail (P < 0.05) resection. The glucose-induced changes in glucagon levels were closely correlated to the respective increments in insulin and C-peptide concentrations (P < 0.01). CONCLUSIONS: The glucose-induced suppression in glucagon levels is lost after a 50% partial pancreatectomy in humans. This suggests that impaired alpha-cell function in patients with type 2 diabetes may also be secondary to reduced beta-cell mass. Alterations in glucagon regulation should be considered as a potential side effect of partial pancreatectomies.
Original languageEnglish
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number8
Pages (from-to)2857-63
Number of pages6
ISSN0021-972X
DOIs
Publication statusPublished - 2009

Bibliographical note

Keywords: Adult; Aged; Blood Glucose; C-Peptide; Female; Glucagon; Glucagon-Secreting Cells; Glucose; Humans; Insulin; Insulin-Secreting Cells; Male; Middle Aged; Pancreatectomy

ID: 18700661