 |
|
Mechanism of Postgastrectomy Hypoglycemia
Kirkwood T. Shultz, MD;
Francis A. Neelon, MD;
Laurance B. Nilsen, MD;
Harold E. Lebovitz, MD
Arch Intern Med. 1971;128(2):240-246.
Abstract
| |
The mechanisms controlling glucose dynamics and insulin secretion of nine patients with symptomatic postprandial hypoglycemia following subtotal gastrectomy were studied. Following oral administration of glucose, the patients showed early hyperglycemia and late hypoglycemia. Insulin secretion was exaggerated; plasma insulin and glucose responses to intravenously administered glucose, tolbutamide sodium, secretin, and glucagon were either low or normal compared to control subjects. Intravenously administered glucose followed by glucagon also given intravenously 25 minutes later caused an exaggerated insulin secretion and delayed hypoglycemia. In two patients, carbohydrate restriction for several months resulted in unchanged early plasma glucose curves, absent later hypoglycemia, and markedly decreased insulin secretion following oral administration of glucose. Carbohydrate refeeding of one patient reestablished postprandial hypoglycemia and exaggerated insulin secretion. The data suggest that postgastrectomy hypoglycemia is caused by an inducible gastrointestinal factor which potentiates glucose-mediated insulin release.
Author Affiliations
Durham, NC
From the Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC. Dr. Shultz is now at Malcolm Grove Hospital, Andrews Air Force Base, Washington, DC. Dr. Nilsen is now in private practice in Phoenix, Ariz.
Footnotes
Received for publication Oct 6, 1970; accepted Dec 4, 1970.
Reprint requests to Department of Medicine, Duke University Medical Center, Durham, NC 27706 (Dr. Lebovitz).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Dumping Syndrome: Pathophysiology and Treatment
Ukleja
Nutr Clin Pract 2005;20:517-525.
ABSTRACT
| FULL TEXT
Pseudoinsulinoma: Alimentary Tract Hypoglycemia Revisited
Collin and Bradley
Arch Surg 1983;118:1087-1090.
ABSTRACT
Effects of Selective Gastric Vagotomy and Pyloroplasty on Oral and Intravenous Glucose Tolerance and Insulin Secretion
Bittner et al.
Arch Surg 1976;111:850-853.
ABSTRACT
Gastric Inhibitory Polypeptide: Response to Oral Glucose After Vagotomy and Pyloroplasty
Thomford et al.
Arch Surg 1974;109:177-182.
ABSTRACT
Postgastrectomy Hypoglycemia: A New Look
H.T.R.
JAMA 1971;217:689-689.
ABSTRACT
|
