Skip to main content
Log in

Pancreatic polypeptide response to a protein-rich meal in diabetic patients with and without neuropathy

  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

A protein-rich meal and insulin-induced hypoglycemia (ITT) are two of the most important stimuli on pancreatic polypeptide (PP) secretion in diabetic patients. Previous studies have shown a reduced PP response to ITT in diabetic patients with autonomic neuropathy (AN). Twelve patients without AN (mean age 44 ± 10.8 yr, mean duration of diabetes 11± 5.6 yr), 9 with. AN (51.4 ± 6 yr, 15.8 ± 6.9 yr) and 9 controls (N) were studied. AN was assessed by the evaluation of the beat-to-beat variation of the heart rate during deep breathing. PP secretion was stimulated by a protein-rich meal (200 g meat, 150 g milk). All insulin-dependent diabetic (IDD) patients lacked circulating PP antibodies. All diabetic patients showed a significant reduction in the early vagal phase compared to controls. This behavior was more evident in diabetic patients with AN and the secondary phase of these two groups overlapped with the response of controls. These data may be explained by the initial alterations of vagal functions not detectable by current methods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Larsson L.I., Sundler F., Häkanson R. Pancreatic-polypeptide, a postulated hormone: identification of its cellular storage site by light and electron microscopic immunocytochemistry. Diabetologia 12: 211, 1976.

    Article  PubMed  CAS  Google Scholar 

  2. Floyd J.C., Fajans S.S., Pek S., Chance R.E. A newly recognized pancreatic polypeptide: plasma levels in health and disease. Recent Prog. Horm. Res. 33: 519, 1977.

    Google Scholar 

  3. Schwartz T.W., Rehfeld J.F., Stadil F., Larsson L.I., Moon N., Chance R.E. Pancreatic polypeptide response to food in duodenal ulcer patients before and after truncal vagotomy. Lancet 1: 1102, 1976.

    Article  PubMed  CAS  Google Scholar 

  4. Schwartz T.W., Holst J.J., Fahrenkrug J., Lindkaer Jensen S., Nielsen O., Rehfeld J.F., Schaffalitzky de Muckadell O.B., Stadil F. Vagal cholinergic regulation of pancreatic polypeptide secretion. J. Clin. Invest. 61: 781, 1978.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  5. Taylor I.L., Feldman M., Richardson C.T., Walsh J.H. Gastric and cephalic stimulation of human pancreatic polypeptide release. Gastroenterology 75: 432, 1978.

    PubMed  CAS  Google Scholar 

  6. Schwartz T.W., Stenquist B., Olbe L. Physiology of mammalian PP and the importance of vagal regulation. In: Bloom S.R. (Ed.), Gut hormones. Edinburgh, Churchill Livingstone, 1978, p. 261.

    Google Scholar 

  7. Taylor I.L., Feldman M. Pancreatic polypeptide and the vagus. In: Rehfeld J.F., Andrup E. (Eds.), Gastrius and vagus. Academic Press, London, 1979, p. 267.

    Google Scholar 

  8. Krarup T., Schwartz T.W., Hilsted J., Madsbad S., Verlaege O., Sestoft L. Impaired response of pancreatic polypeptide to hypoglycemia: an early sign of autonomic neuropathy in diabetics. Br. Med. J. 15: 1544, 1979.

    Article  Google Scholar 

  9. Levitt M.S., Vivik A.I., Sive A.A., Van Tonders, Lund A. Impaired pancreatic polypeptide responses to insulin-induced hypoglycemia in diabetic autonomic neuropathy. J. Clin. Endocrinol. Metab. 50: 445, 1980.

    Article  PubMed  CAS  Google Scholar 

  10. Schwartz T.W. Pancreatic polypeptide. A hormone under vagal control. Gastroenterology 85: 1411, 1983.

    PubMed  CAS  Google Scholar 

  11. Mackay J.D., Page M.Mc.B., Cambridge J., Watkins P.J. Diabetic autonomic neuropathy. Diagnostic values of heart rate monitoring. Diabetologia 18: 471, 1980.

    Article  PubMed  CAS  Google Scholar 

  12. Kohn A., Annibale B., Suriano G., Severi C., Spinella S., Delle Fave G. Gastric acid and pancreatic polypeptide responses to modified sham-feeding: indication of an increased basal vagal tone in a subgroup of duodenal ulcer patients. Gut (in press, 1985).

  13. Krarup T., Madsbad S., Hilsted J., Christensen H.J., Sestoft L., Schwartz T.W. Response of pancreatic polypeptide to hypoglycemia in insulin-dependent diabetics with and without residual beta-cell function. Clin. Endocrinol. (Oxf.) 18: 31, 1983.

    Article  CAS  Google Scholar 

  14. Havafusa T., Toyoshima H., Novaka K., Tarvi S. Impaired response of human pancreatic polypeptide to insulin-induced hypoglycemia in insulin-dependent diabetics. Horm. Metab. Res. 13: 1, 1981.

    Article  Google Scholar 

  15. Hilsted J., Madsbad S., Krarup T., Trouier B., Galbo H., Sestoff L., Schartz T.W. No response of pancreatic hormones to hypoglycemia in diabetic autonomic neuropathy. J. Clin. Endocrinol. Metab. 54: 815, 1982.

    Article  PubMed  CAS  Google Scholar 

  16. Lovengren N.A., Poulsen J., Schwartz T.W. Impaired pancreatic innervation after selective gastric vagotomy. Reduction of the pancreatic polypeptide response to food and insulin hypoglycemia. Scand. J. Gastroenterol. 16: 811, 1981.

    Article  Google Scholar 

  17. Marco J., Hedo J.A., Castillo-Olivares J., Villaneuva M.L. Human pancreatic polypeptide secretion in conditions of exogenous and endogenous hyperglycemia. Diabetologia 19: 418, 1980.

    Article  PubMed  CAS  Google Scholar 

  18. Marco J., Hedo J.A., Villanueva M.L. Control of pancreatic polypeptide secretion by glucose in man. J. Clin. Endocrinol. Metab. 46: 140, 1978.

    Article  PubMed  CAS  Google Scholar 

  19. Tsuda K., Seivo Y., Mori K., Seivo S., Takemura J., Kuzuya H., Imura H. Hyperfunction of the entero-PP axis in non-insulin-dependent diabetes mellitus. Horm. Metab. Res. 15: 581, 1983.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported by C.N.R. grant no. 84.02421.56.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gambardella, S., Felici, M.G., Annibale, B. et al. Pancreatic polypeptide response to a protein-rich meal in diabetic patients with and without neuropathy. J Endocrinol Invest 9, 1–4 (1986). https://doi.org/10.1007/BF03348051

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03348051

Key-words

Navigation