Insulin-induced acid secretion after partial vagotomy in dogs and cats

Stening, G. Frank; Ji, Isenberg

doi:10.1152/ajplegacy.1969.217.4.962

Cited by 19 publications

(6 citation statements)

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“…In repeated tests in one human subject he refuted the 'all-or-none' hypothesis, finding that peak acid output was significantly correlated with the lowest concentration of blood glucose, the fall in blood glucose, the rate of fall of blood glucose, and the maximum fall of blood glucose in any 15 minutes. Similar graded responses to increasing doses of insulin in man have been reported by lsenberg, Stening, Ward, and Grossman (1969), in the dog by Cooke (1969), and in the cat by Stening and Isenberg (1969).…”

Section: Discussionsupporting

confidence: 82%

The gastric secretory response to insulin: an `all-or-none' phenomenon?

Spencer¹,

Grossman²

1971

Gut

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SUMMARY Dogs were prepared with Pavlov pouches which could be perfused with saline so as to detect rapidly changes occurring in acid secretion.Dose-response studies were performed by the intravenous injection of insulin (0-06, 0-12, 0.25, 0-5, or 1-0 unit/kg). Both the magnitude of peak response and the duration of response were dose-related and both were related to the magnitude of fall in plasma glucose.These results are not consistent with an 'all-or-none' hypothesis for insulin-stimulated gastric acid secretion, but favour the alternative hypothesis that insulin provides a graded glycopenic stimulus producing a graded secretory response.It has long been held that the gastric secretory response to insulin hypoglycaemia is an 'all-or-none' phenomenon, initiated when the blood sugar falls below a certain threshold value (40-50 mg/100 ml) and giving a peak response whose magnitude is unrelated to the degree of hypoglycaemia. These assumptions have recently been questioned by Baron (1970), who suggested that insulin hypoglycaemia provided a graded glycopenic stimulus producing a graded vagal response. On repeated studies in one human subject Baron found that peak acid output after insulin was significantly correlated with the lowest blood glucose achieved after insulin, or with the fall-or rate of fall of blood glucose. In these studies peak acid output was defined as that in the two consecutive 15-minute samples giving the highest acid output. It is possible, however, that peak acid output in a much shorter period may be the same with all doses of insulin, but that the duration of the secretory response may be greater when hypoglycaemia is prolonged. The 'all-or-none' assumption would in this case be valid, but would appear refuted when long collection periods were used to define acid output. It was to test this hypothesis that the present experiment was carried out. Dogs were prepared with innervated (Pavlov) pouches which were perfused with saline so that changes in acid secretion could be detected rapidly. Dose response studies were then performed to determine the secretory response to insulin. MethodsTwo mongrel dogs (20.4 and 26-3 kg) were each prepared with a gastric fistula and an innervated fundic pouch (Pavlov). Two Gregory cannulae drained the pouch, at its upper and lower ends (Fig. 1). After a three-week recovery period secretory studies were begun in each dog. These were performed after an overnight fast, during which water but not food was available. The animals stood on tables supported by cloth slings. During each test 154 mM NaCl was infused into a leg vein at a rate just sufficient to maintain patency in a polyethylene cannula which was used to obtain blood samples. In an initial test histamine dihydro-chloride was infused intravenously at a dose of 0-16 mg/kg/hr in order to provide an index of 'maximal' pouch secretion. Pouch secretions were collected as 15-minute samples for two hours. Gastric fistula secretion in this and subsequent studies was collected and discarded.In subsequent studies ...

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Section: Discussionsupporting

confidence: 82%

The gastric secretory response to insulin: an `all-or-none' phenomenon?

Spencer¹,

Grossman²

1971

Gut

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“…Such findings have been reported in man (Baron, 1970;Isenberg, Stening, Ward, and Grossman, 1969), in the dog (Cooke, 1969;Spencer and Grossman, 1971), and in the cat (Stening and Isenberg, 1969), where insulin was administered as a single intravenous injection.…”

Section: Discussionsupporting

confidence: 61%

The gastric secretory response to a continuous insulin infusion in the dog

Dozois¹,

Carter²,

Kirkpatrick³

1973

Gut

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Insulin hypoglycaemia provides a glycopenic stimulus producing a vagal gastric secretory response (Jogi, Strom, and Uvnas, 1949). Earlier investigators (Hollander, Jemerin, and Weinstein, 1942;Davis, Brooks, and Robert, 1965) believed that the gastric acid response to insulin hypoglycaemia represented an 'all-or-none' phenomenon which was (1) initiated when the blood glucose fell to a given threshold value and (2) not related to the degree of hypoglycaemia below such a threshold. The recent finding, however, of a quantitative relationship between insulin dose, hypoglycaemia, and acid secretion (Baron, 1970;Spencer and Grossman, 1971) does not support the 'all-or-none' hypothesis.A single rapid intravenous injection of insulin, such as used by the previously mentioned workers, produces a nadir of hypoglycaemia with gradual restoration of normoglycaemia. In human subjects (Carter, Dozois, and Kirkpatrick, 1972) an infusion of insulin provides a steady level of hypoglycaemia which, if reproducible in the dog, should facilitate correlation studies between blood glucose changes and gastric acid changes.The present investigation was undertaken to study the effect of a continuous infusion of insulin on the blood glucose response in the dog and to establish the relationship between insulin dose, degree of hypoglycaemia, and acid response.

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“…Blood glucoses at 30 minutes were similar after 0.1-0.4 u/kg, but no acid/ glucose correlations were made. Stening and Isenberg (1969)gave catswithgastricfistulasO 03-1 u/kg insulin intravenously and found 0.5 u/kg produced the highest peak 15-minute acid output.…”

Section: In the Unoperated Subjectmentioning

confidence: 95%

Dose response relationships of insulin hypoglycaemia and gastric acid in man

Baron¹

1970

Gut

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SUMMARY Fourteen studies of gastric acid secretion in a basal hour and in the two hours after a single intravenous injection of soluble insulin (0.01 to 0.40 units/kg) were performed in a healthy man. The peak acid output after insulin (measured as the two consecutive 15-minute samples giving the highest acid output) was significantly correlated with the lowest concentration of blood glucose, the fall in blood glucose, the rate of fall of blood glucose, and the maximum fall of blood glucose in any 15 minutes. Peak acid outputs after insulin were similar over the range 0.1 to 0.2 units/kg, and greater than at lower or higher doses.These results are contrary to the accepted assumption that insulin-stimulated acid secretion is an 'all-or-none' phenomenon. They support instead the hypothesis that insulin hypoglycaemia provides a quantitative glycopenic stimulus producing quantitative vagal acid response. Extreme hypoglycaemia, below about 15 mg/100 ml of bloodglucose,inhibitsinsulin-stimulated acid secretion.Certain assumptions about the insulin test have been widely held (Roholm, 1930;Hollander, Jemerin, and Weinstein, 1942) in the 40 years since intravenous insulin was found to be an hypoglycaemic stimulus of gastric acid secretion (Simici, Popescu, and Diculesco, 1927). These assumptions are that the acid response is an 'all-or-none' phenomenon which is (1) initiated when the blood sugar falls to a threshold value of 40-50 mg/100 ml; (2) not related to the degree of hypoglycaemia below this threshold; (3) not dependent on the fall in blood sugar; and (4) not related to the rate of fall of blood sugar.

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Insulin-induced acid secretion after partial vagotomy in dogs and cats

Cited by 19 publications

References 0 publications

The gastric secretory response to insulin: an `all-or-none' phenomenon?

The gastric secretory response to insulin: an `all-or-none' phenomenon?

The gastric secretory response to a continuous insulin infusion in the dog

Dose response relationships of insulin hypoglycaemia and gastric acid in man

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