Pancreatic Glucagon Response in Diabetics after an Oral 50g Glucose Tolerance Test (OGTT)
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Pancreatic glucagon (IRG), insulin (IRI) and blood sugar (BS) were measured in 12 non-obese controls and in 58 untreated, recently diagnosed diabetic patients during an oral glucose tolerance test. The diabetic groups were classified as "mild" ones (fasting blood sugar, FBS, below 140mg/dl), "moderate"(140<FBS<200mg/d<I>l</I>) or "severe"(FBS above 200mg/d<I>l</I>). The glucagon values reported were obtained by using an antibody (30K; Unger) to pancreatic glucagon which showed negligible cross-reaction with gut extracts. After glucose load, specimens were drawn at 30, 60, 90 and 120 minutes. In the controls IRG decreased successively and the fasting IRG, 98±5 pg/m/, declined to 63±5 and 60±6 pg/m/ at 90 and 120 minutes, respectively (p<0.01). In "mild" diabetics the IRG also decreased but not significantly. In "moderate" and "severe" diabetics IRG didn't decrease significantly and it tended to elevate paradoxically despite prolonged hyperglycemia. The reasons why the IRG was elevated paradoxically, after an oral glucose load in "moderate" and "severe" diabetics were not known, although the participation of gut glucagon could be excluded.<BR>In order to elucidate the responsiveness of pancreatic alpha cells to glucose, summations of the changes of IRG or BS at each minutes from the the fasting level after glucose load were caluculated. When IRG or BS became smaller than the fasting level, the difference in value was expressed as a negative sign. The ratio -ΣIRG/ΣBS was 1.96±0.57, 0.11±0.05, -0.002 ± 0.06 and -0.09±0.07 (mean +SEM), in the controls, "mild", "moderate" and "severe" diabetics, respectively. The data indicate that the ratio of the degree of suppression of the pancreatic glucagon release to the glycemic stimulus was distinctly less in diabetics than in normal controls, and that it became still less with the exacerbation of the diabetes mellitus.<BR>From these findings, we speculate that the ratio -ΣIRG/ΣBS after OGTT will be useful in the differential diagnosis of glucose intolerance as a new tool, together with the insulinogenic index at 30 minutes.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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