ALIMENTARY HYPERGLYCEMIA IN PATIENTS WITH SUBTOTAL GASTRECTOMY IS ASSOCIATED WITH DECREASED INSULIN-SECRETION BUT NOT WITH INSULIN-RESISTANCE

Backgrounds, It is not clear whether alimentary hyperglycemia in gastr ectomized patients is related with glucose tolerance or not. Methods, Glucose tolerance, insulin secretion, and peripheral insulin sensitivi ty were evaluated in 36 patients who underwent subtotal gastrectomy fo r gastric cancer using the oral glucose tolerance test (OGTT), the int ravenous glucose tolerance test (IVGTT) and the euglycemic hyperinsuli nemic glucose clamp technique (Glucose clamp). Results. Patients were categorized into three groups by OGTT; 8 cases were in group I (normal ), 19 cases in group LI (alimentary hyperglycemia), and 9 cases in gro up III (glucose intolerance), Both glucose disappearance rate (K value expressed as, %/min) and insuIinogenic index as determined by IVGTT w ere significantly lower in groups II (1.00+/-0.24, 0.21+/-0.18, respec tively) and III (0.90+/-0.18, 0.11+/-0.14, respectively), compared wit h group I (1.58+/-0.71, 0.35+/-0.18, respectively), Peripheral insulin sensitivity as measured by glucose clamp was not decreased in groups II and III. Conclusions, These results suggest that in patients with a limentary hyperglycemia, glucose tolerance was impaired due to a decre ased pancreatic sensitivity to blood glucose and not due to insulin re sistance.