THE RELEASE OF GASTRIC-INHIBITORY PEPTIDE, GLUCAGON-LIKE PEPTIDE-I, AND INSULIN AFTER ORAL GLUCOSE TEST IN COLECTOMIZED SUBJECTS

Background: The physiologic role of the colon as an endocrine organ is not clear. We therefore studied the enteroinsular axis in patients wi th ulcerative colitis after colectomy. Methods: The subjects included 11 patients with a conventional ileostomy, 10 patients with an ileoana l reservoir, and 10 normal controls. The concentrations of glucose, in sulin, gastric inhibitory peptide (GIP), and glucagon-like peptide-I ( GLP-I) were measured in plasma during an oral glucose test. Results: T he peak level of glucose and peak levels and area under the curve (AUG ) of insulin and GIP were higher in patients (P < 0.05). Neither the p eak level nor the AUC of GLP-I differed between patients and controls, but time to peak level was four times longer in patients with an ileo anal reservoir (P < 0.05). Conclusion: Colectomy seems to affect the e nteroinsular axis, leading to hyperinsulinemia and an impaired glucose tolerance. Moreover, patients with an ileoanal reservoir have a slowe r GLP-I response after intake of glucose.