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Glucoseverwertung und Dynamik der Insulinsekretion Messungen nach intraabdominellen Operationen

Glucose-assimilation and dynamics of insulin secretion. Measurements after intra-abdominal operations

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Summary

Insulin concentrations in peripheral venous blood and portal venous blood were measured in 18 patients after intraabdominal operations during 20 standardised glucose-infusion-tests (GIT). The conclusion is as follows:

  1. 1.

    In spite of similar preoperative situations and operative traumatisation the islets reactivity to a constant hyperglycemia and the glucose assimilation is individually very different.

  2. 2.

    Measurements of insulin concentrations in the portal venous blood in man show a significant correlation between the profile of the insulin concentration curve and thek-value; the measurement of the insulin concentrations in peripheral venous blood fails to demonstrate a significant difference.

  3. 3.

    In patients with a pathologic glucose assimilation it is not the insulin secretion that is delayed but the insulin regression (disappearance rate) in portal venous blood.

  4. 4.

    In patients with a normal glucose assimilation the insulin concentration curve in portal venous blood shows an oscillating course during the first 30 min. These oscillations registered for the first time in humans indicate an insulin-induced feedback mechanism of insulin secretion.

Zusammenfassung

Die Insulinkonzentrationen im peripheren Venenblut und Pfortaderblut wurden während 20 standardisierter Glucoseinfusionstests bei 18 Patienten nach intraabdominellen Operationen gemessen. Folgende Schlußfolgerungen werden gezogen:

  1. 1.

    Trotz vergleichbarer präoperativer Ausgangssituation und Traumatisierung durch die Operation ist die Reaktivität des Inselzellapparates auf eine konstante Hyperglykämie und entsprechend die Glucoseverwertung individuell sehr verschieden.

  2. 2.

    Die Messungen der Insulinkonzentration im Pfortaderblut des Menschen ergeben eine signifikante Korrelation zwischen dem Profil der Insulinkonzentrationskurve und demk-Wert; die Meßergebnisse der Insulinkonzentration im peripher-venösen Blut zeigen trotz großerk-Wert-Unterschiede keine eindeutigen Beziehungen.

  3. 3.

    Bei den Patienten mit einer pathologischen Glucoseverwertung ist weniger die Geschwindigkeit der Insulinsekretion als die der Insulinregression aus dem Pfortaderblut verzögert.

  4. 4.

    Bei den Patienten mit einer normalen Glucoseverwertung zeigt die Insulinkonzentrationskurve im Pfortaderblut in den ersten 30 min einen oscillierenden Verlauf. Diese erstmals beim Menschen beobachteten Oscillationen weisen auf eine insulingesteuerte Rückkoppelung der Insulinsekretion hin.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik im Klinikum Westend der Freien Universität Berlin, Germany

    R. Bittner, H. G. Beger, E. Kraas, R. Roscher & M. Borowski

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  1. R. Bittner
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  2. H. G. Beger
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  3. E. Kraas
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  4. R. Roscher
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  5. M. Borowski
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Bittner, R., Beger, H.G., Kraas, E. et al. Glucoseverwertung und Dynamik der Insulinsekretion Messungen nach intraabdominellen Operationen. Klin Wochenschr 53, 861–865 (1975). https://doi.org/10.1007/BF01466959

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  • DOI: https://doi.org/10.1007/BF01466959

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