IMPROVED GLUCOSE-METABOLISM AFTER SUBTOTAL PANCREATECTOMY FOR PANCREATIC-CANCER

Diabetes occurs frequently in patients with pancreatic cancer. To inve stigate the impact of tumour removal, seven patients were studied befo re and after 85 per cent subtotal pancreatectomy for adenocarcinoma of the pancreas. The frequency of diabetes was determined by the oral gl ucose tolerance test. Fasting levels of C peptide and insulin were mea sured in plasma, and insulin secretion was investigated by hyperglycae mic glucose clamp and glucagon stimulation. Six of the seven patients were diabetic before surgery and four required insulin treatment. Impr ovements in diabetic status and glucose metabolism were found in all s even patients after operation, as demonstrated by increased glucose me tabolic capacity during hyperglycaemia. This occurred despite a postop erative reduction in insulin secretion and is explained by the observe d augmentation of whole-body insulin sensitivity after surgery. A diab etogenic factor may be produced by pancreatic adenocarcinoma that may be responsible, directly or indirectly, for the high frequency of diab etes in patients with pancreatic cancer.