[Long-term follow up of acute and chronic pancreatitis during insulin and peptide C secretion and carbohydrate tolerance].

UNLABELLED: The aim of the study was to evaluate the function of pancreatic the B-cell and carbohydrate tolerance after and during pancreatitis. Forty patients (30 men and 10 women) in mean age 41.6 +/- 11.6 years (mean +/- SD) were studied. Analysis of the results was performed in four groups: 1) normal controls, 2) patients after biliary acute pancreatitis (AP) in anamnesis, 3) patients with chronic pancreatitis (ChP) and normal carbohydrate tolerance and 4) patients with chronic pancreatitis and impaired of glucose tolerance (ChP + IGT, WHO classification). Pancreatitic B-cell activity was evaluated by the measurement insulin (IRI) and C-peptide (CP) serum concentrations in fasting state and after 75 g oral glucose and after intravenous glucagon injection (1 mg). Hepatic insulin extraction was estimated from of the serum IRI/CP molar ratio. This study demonstrated impaired function of the pancreatic B-cell in groups after acute pancreatitis and with chronic pancreatitis at normal levels of glycaemia. A progressive reduction of stimulated serum IRI and CP concentrations in groups (2), (3) and (4) was observed. In those groups the increase of serum IRI/CP ratio was found.

CONCLUSIONS

Impaired function of the B-cell after pancreatitis is a frequent complication and to improve metabolic control a mechanism of hepatic insulin clearance reduction is involved.