Exaggerated response of plasma glucagon-like immunoreactivity (GLI) to oral glucose in patients with reactive hypoglycemia.

Shima, Kenji; Tabata, Masako; Tanaka, Akira; Kodaira, Tsukasa; Nishino, Tatsuya; Kumahara, Yuichi

doi:10.1507/endocrj1954.28.249

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Various observations regarding hormonal secretion in PRH patients and controls have been made. Insulin, immunoreactive insulin, glucagon and growth hormone response in patients were similar to controls (1,26). Plasma total glucagon like immunoreactivity concentrations were significantly increased in hypoglycemic group while plasma glucagon immunoreactivity levels were suppressed in the hypoglycemic group and control.…”

Section: Discussionsupporting

confidence: 56%

“…Plasma total glucagon like immunoreactivity concentrations were significantly increased in hypoglycemic group while plasma glucagon immunoreactivity levels were suppressed in the hypoglycemic group and control. (26). Significant elevation of plasma epinephrine or human growth hormone though observed late in the course of GTT, plasma norepinephrine, glucagon, cortisol levels did not change during the latter phase of the test (27).…”

Section: Discussionmentioning

confidence: 88%

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Post prandial plasma glucose level less than the fasting level in otherwise healthy individuals during routine screening

Saha

2006

Indian J Clin Biochem

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During routine screening, some otherwise healthy individuals who showed remarkably lower post prandial (at 2 hour) plasma glucose without any symptom were subjected to extended glucose tolerance test and a few of them to extended post meal tolerance test as well. It was observed that post prandial (at 2 hour) plasma glucose after glucose administration was significantly lower than the fasting level (p<0.05-p<0.001). However, post prandial plasma glucose at 2 hour after their usual meal exhibited a significantly higher level than the fasting and post glucose level (p<0.05-p<0.001). Glucose appears to be a stronger agent than the more natural mixed meal in these individuals in causing post prandial lowering of plasma glucose. Hence, these individuals are to be evaluated with their usual meals before considering further investigations. Like upper limit, there is the need to have a consensus lower limit of reference interval of blood glucose level.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 88%

Post prandial plasma glucose level less than the fasting level in otherwise healthy individuals during routine screening

Saha

2006

Indian J Clin Biochem

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Emptying of the gastric substitute, glucagon-like peptide-1 (GLP-1), and reactive hypoglycemia after total gastrectomy

et al. 1991

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Postprandial glucagon-like peptide-1 (GLP-1), pancreatic glucagon, and insulin were measured in 27 tumor-free patients 43 months (median) after total gastrectomy and in four controls using a 99technetium-labeled 100-g carbohydrate solid test meal. Emptying of the gastric substitute was measured by scintigraphy. Fourteen patients suffered from early dumping symptoms, and five of them also reported symptoms suggestive of reactive hypoglycemia (late dumping). The median emptying half-time (T1/2) of the gastric substitute was 480 sec. Sigstad's dumping score was 8.5 +/- 1.6 (mean +/- SE) in patients with rapid emptying (T1/2 less than 480 sec), and 3.0 +/- 1.5 in patients with slow emptying of the gastric substitute (P = 0.02). The peak postprandial concentration of GLP-1 was 44 +/- 20 pmol/liter in controls, 172 +/- 50 in patients without reactive hypoglycemia, and 502 +/- 116 in patients whose glucose fell below 3.8 mmol/liter during the second postprandial hour. Plasma GLP-1 concentrations peaked at 15 min, and insulin concentrations at 30 min after the end of the meal. A close correlation between integrated GLP-1 responses and integrated insulin responses (r = 0.68) was observed. Multiple regression revealed that three factors were significantly associated with the integrated glucose concentrations during the second hour (60-120 min): Early (first 30 min) integrated GLP-1 (inverse correlation; P = 0.006), age (P = 0.006), and early integrated pancreatic glucagon (P = 0.005). There was a close (inverse) relationship of T1/2 with early integrated GLP-1 and pancreatic glucagon, but not with insulin. Gel filtration of pooled postprandial plasma of gastrectomized individuals revealed that all glucagon-like immunoreactivity eluted at Kd 0.30 (Kd, coefficient of distribution), the elution position of glicentin. Almost all of the GLP-1 like immunoreactivity eluted at Kd 0.60, the elution position of gut GLP-1. The authors contend that GLP-1-induced insulin release and inhibition of pancreatic glucagon both contribute to the reactive hypoglycemia encountered in some patients following gastric surgery. Rapid emptying seems to be one causative factor for the exaggerated GLP-1 release in these subjects.

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Hypoglycemia and Hypoglycemic Syndromes

Lamos¹,

Younk²

2016

Endocrinology: Adult and Pediatric

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Exaggerated response of plasma glucagon-like immunoreactivity (GLI) to oral glucose in patients with reactive hypoglycemia.

Cited by 4 publications

References 16 publications

Post prandial plasma glucose level less than the fasting level in otherwise healthy individuals during routine screening

Post prandial plasma glucose level less than the fasting level in otherwise healthy individuals during routine screening

Emptying of the gastric substitute, glucagon-like peptide-1 (GLP-1), and reactive hypoglycemia after total gastrectomy

Hypoglycemia and Hypoglycemic Syndromes

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