Islet cell responses to glucose in human transplanted pancreas

D. Elahi, B. A. Clark, M. McAloon-Dyke, G. Wong, R. Brown, M. Shapiro, K. L. Minaker, T. L. Flanagan, T. Pruett, R. Gingerich, J. Hanks, D. K. Andersen

Research output: Contribution to journalArticle

Abstract

Postsurgery, pancreas transplantation results in alterations of carbohydrate metabolism. Additionally, immunosuppressive therapy impacts on glucose regulation. We evaluated the hormonal and metabolic responses of pancreas allografts, utilizing the hyperglycemic clamp technique coupled with the tritiated glucose methodology, in 11 volunteers who had received simultaneous pancreas-kidney transplantation (P-K) with systemic drainage. Their responses were compared with seven volunteers who had received only a kidney (K) graft and with seven normal control (C) volunteers. Although basal glucose and hepatic glucose output were similar in all three groups, basal insulin, C-peptide, glucagon, and pancreatic polypeptide were highest in the P-K group and lowest in normal subjects. During hyperglycemia, all groups showed a similar characteristic, initial complete suppression of hepatic glucose production, with recovery followed by a later suppression. Peripheral glucose uptake was similar in P-K and C subjects but decreased in K patients. Systemic insulin levels were fourfold higher in the pancreas transplant patients than in healthy subjects. Thus, under basal and hyperglycemic stimulation, 1) hepatic glucose homeostasis is regulated normally, even with pancreatic drainage into the systemic circulation; 2) overall glucose disposal is normal in P-K patients because of marked hyperinsulinemia; and 3) there is loss of tonic inhibition of endocrine pancreatic function secondary to pancreatic denervation.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume261
Issue number6 24-6
StatePublished - 1991
Externally publishedYes

Fingerprint

Islets of Langerhans
Pancreas
Pancreas Transplantation
Glucose
Kidney Transplantation
Volunteers
Drainage
Liver
Insulin
Transplants
Pancreatic Polypeptide
C-Peptide
Clamping devices
Carbohydrate Metabolism
Hyperinsulinism
Denervation
Immunosuppressive Agents
Glucagon
Grafts
Hyperglycemia

Keywords

  • Denervation
  • Diabetes mellitus
  • Hepatic glucose production
  • Hyperglycemia
  • Systemic drainage

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Physiology

Cite this

Elahi, D., Clark, B. A., McAloon-Dyke, M., Wong, G., Brown, R., Shapiro, M., ... Andersen, D. K. (1991). Islet cell responses to glucose in human transplanted pancreas. American Journal of Physiology - Endocrinology and Metabolism, 261(6 24-6).

Islet cell responses to glucose in human transplanted pancreas. / Elahi, D.; Clark, B. A.; McAloon-Dyke, M.; Wong, G.; Brown, R.; Shapiro, M.; Minaker, K. L.; Flanagan, T. L.; Pruett, T.; Gingerich, R.; Hanks, J.; Andersen, D. K.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 261, No. 6 24-6, 1991.

Research output: Contribution to journalArticle

Elahi, D, Clark, BA, McAloon-Dyke, M, Wong, G, Brown, R, Shapiro, M, Minaker, KL, Flanagan, TL, Pruett, T, Gingerich, R, Hanks, J & Andersen, DK 1991, 'Islet cell responses to glucose in human transplanted pancreas', American Journal of Physiology - Endocrinology and Metabolism, vol. 261, no. 6 24-6.
Elahi D, Clark BA, McAloon-Dyke M, Wong G, Brown R, Shapiro M et al. Islet cell responses to glucose in human transplanted pancreas. American Journal of Physiology - Endocrinology and Metabolism. 1991;261(6 24-6).
Elahi, D. ; Clark, B. A. ; McAloon-Dyke, M. ; Wong, G. ; Brown, R. ; Shapiro, M. ; Minaker, K. L. ; Flanagan, T. L. ; Pruett, T. ; Gingerich, R. ; Hanks, J. ; Andersen, D. K. / Islet cell responses to glucose in human transplanted pancreas. In: American Journal of Physiology - Endocrinology and Metabolism. 1991 ; Vol. 261, No. 6 24-6.
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