EFFECT OF ACUTE HYPERGLYCEMIA ON BASAL AND CHOLECYSTOKININ STIMULATEDEXOCRINE PANCREATIC-SECRETION IN HUMANS

This study was undertaken to investigate the effect of acute hyperglyc emia on pancreatico-biliary secretion in healthy subjects. Duodenal ou tputs of bilirubin, amylase, trypsin and bicarbonate were measured by aspiration using a recovery marker under basal condition for 75 min an d during continuous infusion of CCK (0.5 IDU/kg.h for 60 min). Seven h ealthy subjects participated in two experiments performed in random or der during normoglycemia and during acute hyperglycemic clamping at 15 mmol/l. At regular intervals plasma PP levels were determined as an i ndirect measure of vagal-cholinergic tone. Basal pancreatico-biliary s ecretion was significantly (p<0.05) reduced during acute hyperglycemia , CCK significantly (p<0.05) increased bilirubin, amylase and trypsin output both during normo- and hyperglycemia. During the initial 30 min of CCK infusion the bilirubin, amylase and trypsin outputs were signi ficantly (p<0.05) inhibited in the hyperglycemic experiment compared t o normoglycemia. In the following 30 min of CCK infusion the bilirubin , amylase and trypsin output were not different between hyper and norm oglycemia. Basal and CCK-stimulated plasma PP concentrations were sign ificantly (p<0.05) reduced during hyperglycemia. In summary: 1) basal pancreatico-biliary secretion is significantly reduced during acute hy perglycemia 2) during hyperglycemia CCK-stimulated pancreatico-biliary secretion is also significantly reduced with the pattern of a delayed response 3) hyperglycemia inhibits basal and CCK-stimulated PP secret ion suggesting impaired vagal-cholinergic activity during hyperglycemi a.