Summary
The aim of the present study was to evaluate the insulin and glucagon responses to various stimuli in patients following pancreatic transplantation. Four Type 1 (insulin-dependent) diabetic patients with end-stage renal failure who had received a cadaveric segmental, neoprene-injected, pancreas transplant, in association with kidney transplantation, were investigated. Free-insulin, pancreatic glucagon, and growth hormone concentrations were measured after both oral and intravenous glucose tolerance tests, and following tolbutamide, arginine and arginine plus somatostatin infusions. Tests were performed 1 month (three cases) and 30 months (one case) after surgery, when no insulin administration was required. Four non-diabetic kidney grafted patients, matched for duration of graft survival and immunosuppressive treatment (steroids, azathioprine and anti-lymphocyte-globulins), served as control subjects. Impaired glucose tolerance was present in all diabetic and control patients. This was possibly related to immunosuppressive treatment. In comparison with control subjects, insulin release was normal in response to arginine and tolbutamide but was reduced in response to oral and intravenous glucose, while glucagon and growth hormone release were similar in both groups. Somatostatin was less effective in diabetic patients than in control subjects in suppressing insulin and glucagon release.
Article PDF
Similar content being viewed by others
References
Sutherland DER (1981) Pancreas and islets transplantation. II, Clinical Trials. Diabetologia 20: 435–450
Dubemard JM, Traeger J, Neyra P, Touraine JL, Tranchant D, Blanc Brunat N (1978) New method of preparation of a segmental pancreatic graft for transplantation. Trials in dogs and in man. Surgery 84: 633–639
Sutherland DER, Goetz FC, Najarian JS (1980) Report of twelve clinical cases of segmental pancreas transplantation at the University of Minnesota. Transplant Proc 12: 33–39
Traeger J, Dubernard JM, Ruitton AM, Malik MC, Touraine JL (1980) Clinical experience with 15 neoprene injected pancreatic allotransplants. Transplant Proc 12: 44–50
Ostman J, Arner P, Groth GC, Gunnarson R, Heding L, Lundgren G (1980) Plasma C-peptide and serum insulin antibodies in diabetic patients receiving pancreas transplant. Diabetologia 19: 25–30
Sutherland DER, Najarian JS, Greensberg BZ, Senske BJ, Anderson GE, Francis RS, Goetz FC (1981) Hormonal and metabolic effects of a pancreatic endocrine graft. Ann Int Med 95: 537–541
Touraine JL, Betuel H, Malik MC, Dubernard JM, Traeger J (1980) Immunologic preparation of the pancreatic transplant recipient. Transplant Proc 12: 11–14
Nakagawa S, Nakayama H, Sasaki T, Yoshino K, Ying Yu Y, Shinozaki K, Aoki S, Mashimo K (1973) A simple method for the determination of serum free insulin levels in insulin-treated patients. Diabetes 22: 590–600
Heding LG (1972) Determination of total serum insulin in insulin treated diabetic patients. Diabetologia 8: 260–266
Desbuquois B, Aurbach GD (1971) Use of polyethylene glycol to separate free and antibody bound peptide hormones in radioimmunoassay. J Clin Endocr 33: 732–738
WHO Expert Committee on Diabetes Mellitus (1980) World Health Organisation, Geneva, pp 9–12
Conard V (1955) Mesure de l'assimilation du glucose: bases theoriques et application cliniques. Acta Medica Belgica 10: 148–155
Heptner W, Neubauer HP, Schleyerbach R (1974) Glucose tolerance and insulin secretion in rabbits and dogs after ligation of the pancreatic duct. Diabetologia 10: 193–196
Creutzfeldt W(1979) The incretin concept today. Diabetologia 16: 75–85
Unger RH, Eisentraut AM (1969) Entero-insular axis. Arch Intern Med 123: 261–266
Bloom SR, Vaughan NJA, Russel RCG (1974) Vagal control of glucagon release in man. Lancet 2: 546–549
Katinuma H, Kaneto A, Kuzuya T, Nakao K (1968) Effects of methacholine on insulin secretion in man. J Clin Endocrinol Metab 28: 1384–1388
Lund B, Aagaard P, Deckert T (1975) Effect of vagothomy on insulin release after oral and intra-venous glucose administration. Scand J Gastroent 10: 777–780
Gerich JE, Charles MA, Grodsky GM (1974) Characterization of the effects of arginine and glucose on glucagon and insulin release from the perfused rat pancreas. J Clin Invest 54: 833–841
Hansen AP, Johansen K (1970) Diurnal pattern of blood glucose, serum FFA, insulin, glucagon and growth hormone in normals and juvenile diabetics. Diabetologia 6: 27–33
Norfleet WT, Pagliara AS, Haymond MV, Matschinsky F (1975) Comparison of alpha and beta cell secretory responses in islets isolated with collagenase and in the isolated perfused pancreas of rats. Diabetes 24: 961–970
Chiba T, Taminato T, Kadowaki S, Chihara K, Matsukura S, Nozawa N, Seino Y, Fujita T (1981) Reverseal of increased gastric somatostatin in streptozotocin-diabetic rats by whole pancreas transplantation. Diabetes 30: 724–727
Najarian JS, Sutherland DER, Simmons RL, Howard RJ, Kjellstrand CM, Ramsay RC, Goetz FC, Fryd DS, Sommer BG (1979) Ten years experience with renal transplantation in juvenile onset diabetics. Ann Surg 190: 487–500
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pozza, G., Traeger, J., Dubernard, J.M. et al. Endocrine responses of type 1 (insulin-dependent) diabetic patients following successful pancreas transplantation. Diabetologia 24, 244–248 (1983). https://doi.org/10.1007/BF00282707
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00282707