The American Journal of Digestive Diseases

, Volume 23, Issue 12, pp 1107–1114 | Cite as

A prospective study of glucose tolerance, insulin, C-peptide, and glucagon responses in patients with pancreatic carcinoma

  • Stanley S. Schwartz
  • Adina Zeidler
  • A. R. Moossa
  • Sonny F. Kuku
  • Arthur H. Rubenstein
Original Articles


Ninety-nine patients suspected of having pancreatic carcinoma were studied prospectively for carbohydrate tolerance. Thirty-two patients were proven subsequently to have pancreatic carcinoma; the remainder served as a control group. There was an increased incidence of carbohydrate intolerance in patients with pancreatic carcinoma compared to the control group. Insulin and C-peptide measurements during glucose tolerance tests suggest abnormal beta cell function and possibly insulin resistance as causes for this abnormality. Although factors related to malignancy in general could partly account for the results, a specific factor occurring in patients with pancreatic carcinoma must also be considered as it could serve as a marker for the early detection of this disease.


Public Health Glucose Carcinoma Carbohydrate Insulin Resistance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Zimmerman B: Editorial. Diabetes and gross lesions of the pancreas. J Clin Endocrinol Metab 14:481–483, 1954Google Scholar
  2. 2.
    Bell ET: Carcinoma of the pancreas II. The relation of carcinoma of the pancreas to diabetes mellitus Am J Pathol 33:499–523, 1957PubMedGoogle Scholar
  3. 3.
    Berkowitz D, Greenberg L, Glassman S: The intravenous tolbutamide test as a diagnostic aid in carcinoma of the pancreas. Am J Med Sci 243:150–154 (228–232), 1963Google Scholar
  4. 4.
    Birnbaum D, Kleeberg J: Carcinoma of the pancreas: A clinical study based on 84 cases. Ann Intern Med 48:1171–1184, 1958PubMedGoogle Scholar
  5. 5.
    Clark CG, Mitchell PEG: Diabetes mellitus and primary carcinoma of the pancreas. Br Med J 2:1259–1262, 1961Google Scholar
  6. 6.
    Glicksman AS, Rawson RW: Diabetes and altered carbohydrate metabolism in patients with cancer. Cancer 9:1227–1234, 1956PubMedGoogle Scholar
  7. 7.
    Green RC, Jr, Bagenstoss AH, Sprague RG: Diabetes mellitus in association with primary carcinoma of the pancreas. Diabetes 7:308–311, 1958PubMedGoogle Scholar
  8. 8.
    Karmody AJ, Kyle J: The association between carcinoma of the pancreas and diabetes mellitus. Br J Surg 56:362–364, 1969PubMedGoogle Scholar
  9. 9.
    Murphy R, Smith FH: Abnormal carbohydrate metabolism in pancreatic carcinoma. Med Clin North Am 47:397–405, 1963PubMedGoogle Scholar
  10. 10.
    Stein MW: Methods of Enzymatic Analysis. HV Bergmener (ed). Weinheim, Verlag Chemic, 1965, pp 117–123Google Scholar
  11. 11.
    Morgan CR, Lazarow A: Immunoassay of insulin: Two antibody system. Plasma levels of normal, subdiabetic and diabetic rats. Diabetes 12:115–126, 1963Google Scholar
  12. 12.
    Melani F, Rubenstein AH, Oyer PF, Steiner DF: Identification of proinsulin and C-peptide in human serum by a specific immunoassay. Proc Natl Acad Sci USA 67:148–155, 1970PubMedGoogle Scholar
  13. 13.
    Kuku SF, Zeidler A, Emmanouel DS, Katz AI, Rubenstein AH: Heterogeneity of plasma glucagon: Patterns in chronic renal failure and diabetes. J Clin Endocrinol Metab 42:173–176, 1976PubMedGoogle Scholar
  14. 14.
    Prout TE: The use of screening and diagnostic procedures: The oral glucose tolerance test. Diabetes Mellitus. KE Sussman, RJS Metz (eds). A.D.A., New York, 1975, pp 57–66Google Scholar
  15. 15.
    Siperstein MD: The glucose tolerance test: A pitfall in the diagnosis of diabetes mellitus. Adv Intern Med 20:297–323, 1975PubMedGoogle Scholar
  16. 16.
    Rubenstein AH, Steiner DF, Horwitz D, Mako M, Block MD, Starr JI, Kuzuya H, Melani J: CLinical significance of circulating proinsulin and C-peptide. Rec Prog Horm Res 33:435–475, 1977Google Scholar
  17. 17.
    Lisker SA, Brody JI, Beizer LH: Abnormal carbohydrate metabolism in patients with malignant blood dyscrasias. Am J Med Sci252:62–68 (282–288), 1966PubMedGoogle Scholar
  18. 18.
    Lipman RL, Rawkins P, Love T, Triebwasser J, Lecocq FR, Schnure JJ: Glucose intolerance during decreased physical activity in man. Diabetes 2:101–107, 1972Google Scholar
  19. 19.
    Pimstone B: Endocrine function in protein calorie malnutrition. Clin Endocrinol 5:79–95, 1976Google Scholar

Copyright information

© Digestive Disease Systems, Inc 1978

Authors and Affiliations

  • Stanley S. Schwartz
    • 1
  • Adina Zeidler
    • 1
  • A. R. Moossa
    • 1
  • Sonny F. Kuku
    • 1
  • Arthur H. Rubenstein
    • 1
  1. 1.Departments of Medicine and SurgeryUniversity of ChicagoChicago

Personalised recommendations