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Studies of the Entero‐insular Axis Following Pancreas Transplantation in Man: Neural or Hormonal Control?
Author(s) -
Clark J.D.A.,
Wheatley T.,
Brons I.G.M.,
Calne R.Y.,
Bloom S.R.
Publication year - 1989
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1989.tb01285.x
Subject(s) - medicine , transplantation , hormone , pancreas transplantation , physiology , surgery , kidney transplantation
To study the role of hormonal and neural factors in the control of the entero‐insular axis the insulin, C‐peptide, and glucose‐dependent insulinotropic peptide (GIP) responses to oral and intravenous glucose were investigated in 5 patients who had received a combined kidney and paratopic pancreas transplant, with physiological portal venous drainage. The incremental areas under the insulin and C‐peptide responses to oral glucose were significantly greater than the responses to intravenous glucose (insulin: patients 7983 ± 1937 (±SE) vs 3513 ± 2188 mU I −1 min, p < 0.002, control subjects 5505 ± 1035 vs 1066 ± 484 mU I −1 min, p < 0.004; C peptide: patients 440 ± 80 vs 144 ± 61 nmol I −1 min, p < 0.01, control subjects 200 ± 38 vs 63 ± 16 nmol I −1 min, p < 0.01). The incretin effects for insulin (patients 4.4 ± 1.4, control subjects 7.7 ± 1.8) and C‐peptide (patients 4.4 ± 0.9, control subjects 3.7 ± 0.9) and the GIP responses to oral and intravenous glucose were not significantly different between transplant patients and control subjects. As the incretin effect was preserved, despite a denervated pancreas, hormonal rather than neural factors may be more important in mediating increased insulin secretion after oral carbohydrate. The normal GIP response is compatible with its proposed role as an insulinotropic hormone.