Serum Insulin after Intravenous Administration of Glucose before and after Total Vagotomy

Aagaard, Peter; Deckert, T.; Hj, Fenger

doi:10.1080/00365521.1973.12096771

Cited by 12 publications

(2 citation statements)

References 9 publications

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“…In studies using the isolated, perfused rat pancreas, acetylcholine induced a prompt release of insulin [57], and direct vagal stimulation resulted in a release of insulin [58,59]. Several studies [60][61][62][63] have demonstrated that after SPV or SGV plus P, basal serum insulin levels and the postprandial insulin output were not changed. After TV, the insulin response to an oral glucose tolerance test or a test meal was either diminished [60,62] or unchanged [61,63,64].…”

Section: Insulinmentioning

confidence: 99%

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Effect of vagotomy on gastrointestinal hormones

1979

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Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin are elevated after all types of vagotomy. The postvagotomy hypergastrinemia is due to the change in pH in the antral lumen or the gastric motility changes, both of which may lead to a proliferation of G cells. The reduction in pancreatic secretion after vagotomy is not due to changes in intestinal hormone release, but may be caused by the interruption of a postulated enteropancreatic reflex. Postprandial GIP release and serum insulin levels are not affected by vagotomy, but basal GIP levels are increased after vagotomy. Postprandial pancreatic polypeptide release is nearly abolished by vagotomy, but seems to normalize in the later postoperative course. These findings may be important for the interpretation of pathophysiologic changes after vagotomy.

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Section: Insulinmentioning

confidence: 99%

“…Several studies [60][61][62][63] have demonstrated that after SPV or SGV plus P, basal serum insulin levels and the postprandial insulin output were not changed. After TV, the insulin response to an oral glucose tolerance test or a test meal was either diminished [60,62] or unchanged [61,63,64].…”

Section: Insulinmentioning

confidence: 99%

Effect of vagotomy on gastrointestinal hormones

1979

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Effects of Selective Gastric Vagotomy and Pyloroplasty on Oral and Intravenous Glucose Tolerance and Insulin Secretion

Bittner¹

1976

Arch Surg

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The effect of truncal and selective vagotomy on the release of pancreatic glucagon, insulin and enteroglucagon

Russell

Thomson

Bloom

1974

Journal of British Surgery

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SUMMARYTo study the effect of vagotomy on the endocrine function of the pancreas, plasma pancreatic glucagon levels were studied during insulin-induced hypoglycaemia, and VAGOTOMY in one of its various forms is the most widely practised surgical treatment for chronic duodenal ulcer, but there remains controversy as to which variant is preferable. The theoretical argument in favour of selective vagotomy is that it preserves the vagal innervation of the pancreas and liver, but there is surprisingly little information about the effect of truncal and selective vagotomy on pancreatic function.On the basis of its amylase output in response to insulin-induced hypoglycaemia, McKelvey et al. (1973) have shown that the exocrine function of the pancreas is reduced by truncal vagotomy compared with selective vagotomy. There is some evidence from animal studies that vagal stimulation results in the release of glucagon (Bloom et a]., 1974) and of insulin (Daniel and Henderson, 1967), but the effect of vagotomy on pancreatic endocrine function in man has not been studied, and indeed there is no evidence that in man vagal innervation plays any part in the control of the secretion of insulin and glucagon. The present investigation was performed to see whether the endocrine function of the pancreas was differently affected by truncal and selective vagotomy, as judged by the plasma levels of pancreatic glucagon during insulin-induced hypoglycaemia and the plasma insulin levels after the ingestion of glucose.Preliminary studies have demonstratcd that the levels of plasma enteroglucagon in response to oral glucose are greater following vagotomy and a drainage procedure than in normal people (Bloom et al., 1972), but the numbers studied were too small to determine whether there was any difference between truncal and selective vagotomy. Further studies have been performed to clarify this point. On the basis of the result of the insulin test the patients who had had a complete vagotomy by the criteria of Hollander (1948) were selected for this study. There were 24 patients after truncal vagotomy and 17 patients after selective vagotomy chosen for investigation. All the patients had had a drainage procedure with the vagotomy, either a pyloroplasty or gastrojejunostomy. The groups selected were similar in all respects. Materials and methods Clinical Insulin and enteroglucagon release after oral glucose:After an overnight fast 16 patients who had undergone a truncal vagotomy and 21 patients who had undergone a selective vagotomy were challenged with oral hypertonic glucose (200 ml of a 50 per cent solution). All the patients had had a drainage procedure with the vagotomy, either a pyloroplasty or a gastrojejunostomy. The groups were similar in all respects. Blood samples were taken in the same manner as described above; two samples prior to the glucose meal, and at 10, 20, 30, 40, 60, 90 and 120 minutes after the challenge. The plasma insulin concentration, the plasma enteroglucagon concentration and the blood sugar concentration were me...

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Serum Insulin after Intravenous Administration of Glucose before and after Total Vagotomy

Cited by 12 publications

References 9 publications

Effect of vagotomy on gastrointestinal hormones

Effect of vagotomy on gastrointestinal hormones

Effects of Selective Gastric Vagotomy and Pyloroplasty on Oral and Intravenous Glucose Tolerance and Insulin Secretion

The effect of truncal and selective vagotomy on the release of pancreatic glucagon, insulin and enteroglucagon

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