Evidence of extrapancreatic glucagon secretion in man

A Lund, JI Bagger, NJ Wewer Albrechtsen… - Diabetes, 2016 - Am Diabetes Assoc
Diabetes, 2016Am Diabetes Assoc
Glucagon is believed to be a pancreas-specific hormone, and hyperglucagonemia has been
shown to contribute significantly to the hyperglycemic state of patients with diabetes. This
hyperglucagonemia has been thought to arise from α-cell insensitivity to suppressive effects
of glucose and insulin combined with reduced insulin secretion. We hypothesized that
postabsorptive hyperglucagonemia represents a gut-dependent phenomenon and
subjected 10 totally pancreatectomized patients and 10 healthy control subjects to a 75-g …
Glucagon is believed to be a pancreas-specific hormone, and hyperglucagonemia has been shown to contribute significantly to the hyperglycemic state of patients with diabetes. This hyperglucagonemia has been thought to arise from α-cell insensitivity to suppressive effects of glucose and insulin combined with reduced insulin secretion. We hypothesized that postabsorptive hyperglucagonemia represents a gut-dependent phenomenon and subjected 10 totally pancreatectomized patients and 10 healthy control subjects to a 75-g oral glucose tolerance test and a corresponding isoglycemic intravenous glucose infusion. We applied novel analytical methods of plasma glucagon (sandwich ELISA and mass spectrometry–based proteomics) and show that 29–amino acid glucagon circulates in patients without a pancreas and that glucose stimulation of the gastrointestinal tract elicits significant hyperglucagonemia in these patients. These findings emphasize the existence of extrapancreatic glucagon (perhaps originating from the gut) in man and suggest that it may play a role in diabetes secondary to total pancreatectomy.
Am Diabetes Assoc