Glucagon levels and ketogenesis in human diabetes following total or partial pancreatectomy and severe chronic pancreatitis |
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Authors: | Stefano Del Prato Fausto Riva Antonio Devidé Romano Nosadini Domenico Fedele Antonio Tiengo |
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Institution: | (1) Centro Antidiabetico, Ospedale Civile di Treviso, Italy;(2) Istituto di Medicina Clinica Divisione di Gerontologia e Malattie del Ricambio, Università di Padova, Italy |
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Abstract: | Summary In three groups of patients with insulin-dependent diabetes following total (n=5) or partial (n=5) pancreatectomy or chronic
pancreatitis (n=7) and in a group of idiopathic diabetics, ketogenic capacity following insulin withdrawal and during a 24-h
fast was studied. Basal glucagon values were significantly increased in all diabetic groups with no significant intergroup
differences. Basal ketone body values and their increase during starvation and insulin withdrawal were high and not different
in totally pancreatectomized and primary diabetics, both showing unmeasurable C-peptide levels. On the contrary, ketogenesis
was reduced in partially pancreatectomized and in pancreatitis diabetics with persistent levels of C-peptide. Our data confirmed
the persistence of immunoreactive glucagon after pancreatectomy and demonstrated that ketogenesis is not suppressed in pancreatectomized
diabetics and depends above all on residual B-cell function. A possible ketogenic effect of extra-pancreatic glucagon-like
substances cannot be excluded. |
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Keywords: | Glucagon Ketogenesis Pancreatectomy Pancreatic diabetes |
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