Clinical use of glucagon and insulin in therapy of fulminant hepatic failure

Abstract

We have reported 5 cases of fulminant hepatic failure who were treated with a combination of glucagon and insulin. Marked improvement of hepatic coma was characteristically noted in all cases.

Glucagon-like polypeptide and insulin contents in the brain from acute hepatic failure dogs

“…Of the 64 cases with fulminant hepatitis, who received the infusion of glucagon and insulin, 29 cases (45.3%) were recovered [10]. This survival rate is very high as compared with the rates previously reported in Japan [13].…”

“…Ten units insulin (Insulin Novo Regular, Kodama Ltd., Tokyo, Japan) and 1 mg glucagon (Glucagon Novo, Kodama Ltd., Tokyo) were added to 500ml of 10% glucose solution containing 0.1% BSA, and the mixture was continuously infused for lh at a flow speed of 5ml/ min to dogs treated with dimethylnitrosamine, which is similar as the infusion speed of glucagon-insulin therapy for fulminant hepatitis patients [10].…”

“…A simultaneous injection of glucagon and insulin was used to accelerate the repair process of damaged liver as a therapeutic maneuver for fulminant hepatitis [1,10]. As glucagon and insulin may show their extensive hormonal actions on many organs, the clinical efficacy of this therapy should be considered with respect to improvement of abnormal metabolisms observed in the skeletal muscle and central nervous system (CNS) of hepatic failure.…”

Treatment of Fulminant Hepatic Failure – Is There Light at the End of the Tunnel?

“…Similar results were found in rats but not rabbits treated with chemical toxins known to induce FHF (42,43). Based on these findings and retrospective reviews showing a survival advantage compared with historical controls (44,45), two major prospective, randomized controlled trials were performed (46,47). Once again, the results were discouraging.…”