Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution
- PMID: 6997121
- DOI: 10.1007/BF00275269
Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution
Abstract
The influence of impaired digestion on nutrient induced release of gastric inhibitory polypeptide (GIP) and insulin have been investigated in patients with chronic pancreatitis. All patients had massive steatorrhea (> 25 g/24 h), and glucose intolerance. A standard liquid test meal comprising fat and glucose were ingested with or without pancreatic enzyme substitution (9.0 g pancreatin). In the presence of pancreatin the response of serum levels of GIP to the test meal was significantly enhanced (81.2 vs 194.5 microgram/l X 180 min). Concurrently, the insulin response was augmented (3.4 vs 6.4 U/l X 180 min), resulting in improved glucose tolerance. Addition of pancreatin also significantly augmented the GIP response to oral fat (100 g), but not to oral glucose (100 g). In patients with pancreatogenic steatorrhea the insulin response to an IV glucose infusion (0.7 g/kg/h for 90 min) was augmented by oral fat only after addition of 9.0 g pancreatin to the fat load (3.5 vs 7.3 U/l X 180 min). After restoration of the GIP response to fat by pancreatin, the inhibitory effect of IV glucose on fat-induced GIP increase was restored. These data indicate that the GIP response to a mixed meal or triglycerides is dependent on the absorption of nutrients. In patients with chronic pancreatitis improvement of pancreatogenic insufficiency reverses the impaired GIP response, restores the incretin effect of fat, and improves glucose tolerance.
Similar articles
-
Response of gastric inhibitory polypeptide (GIP) to test meal in chronic pancreatitis--relationship to endocrine and exocrine insufficiency.Diabetologia. 1976 Dec;12(6):609-12. doi: 10.1007/BF01220638. Diabetologia. 1976. PMID: 1001849
-
Impaired feedback control of fat induced gastric inhibitory polypeptide (GIP) secretion by insulin in obesity and glucose intolerance.Eur J Clin Invest. 1979 Apr;9(2 Pt 1):129-35. doi: 10.1111/j.1365-2362.1979.tb01678.x. Eur J Clin Invest. 1979. PMID: 111943 Clinical Trial.
-
Clinical studies with gastric inhibitory polypeptide.World J Surg. 1979 Sep 20;3(5):553-8. doi: 10.1007/BF01654758. World J Surg. 1979. PMID: 516774
-
Clinical aspects of GIP secretion.Acta Diabetol Lat. 1982 Jan-Mar;19(1):1-11. doi: 10.1007/BF02581180. Acta Diabetol Lat. 1982. PMID: 6280423 Review.
-
Glucose-dependent insulinotropic polypeptide: effects on insulin and glucagon secretion in humans.Dan Med J. 2016 Apr;63(4):B5230. Dan Med J. 2016. PMID: 27034187 Review.
Cited by
-
[Other specific types of diabetes and exocrine pancreatic insufficiency (update 2023)].Wien Klin Wochenschr. 2023 Jan;135(Suppl 1):18-31. doi: 10.1007/s00508-022-02123-x. Epub 2023 Apr 20. Wien Klin Wochenschr. 2023. PMID: 37101022 Free PMC article. German.
-
[Position paper: Exocrine pancreatic insufficiency and diabetes mellitus].Wien Klin Wochenschr. 2012 Dec;124 Suppl 2:100-3. doi: 10.1007/s00508-012-0290-2. Wien Klin Wochenschr. 2012. PMID: 23250472 German.
-
Glycemic Change After Pancreaticoduodenectomy: A Population-Based Study.Medicine (Baltimore). 2015 Jul;94(27):e1109. doi: 10.1097/MD.0000000000001109. Medicine (Baltimore). 2015. PMID: 26166104 Free PMC article.
-
Pancreatic enzyme replacement therapy in subjects with exocrine pancreatic insufficiency and diabetes mellitus: a real-life, case-control study.Diabetol Metab Syndr. 2024 Feb 9;16(1):39. doi: 10.1186/s13098-024-01265-4. Diabetol Metab Syndr. 2024. PMID: 38331895 Free PMC article.
-
Gut hormones and gastrointestinal motility in children with cystic fibrosis.Dig Dis Sci. 1992 Feb;37(2):187-92. doi: 10.1007/BF01308170. Dig Dis Sci. 1992. PMID: 1735334
References
MeSH terms
Substances
LinkOut - more resources
Medical