The Effect of Graded Insulin Doses on Incompletely Vagotomized Subjects

Ji, Isenberg; Gf, Stening; Jl, Pitcher; Am, Brooks

doi:10.1016/s0016-5085(19)33676-5

Cited by 8 publications

(2 citation statements)

References 8 publications

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“…With the dose of insulin used (0.2 units/kg) no further significant increase in acid output would be expected on doubling the dose (Isenberg, Stening, Ward & Grossman, 1969;Isenberg, Stening, Pitcher & Brooks, 1970), and the acid response to twice a sub-threshold dose of pentagastrin would either still be sub-threshold or perhaps in a few instances would amount to a very small acid response. We therefore conclude that potentiation of acid output has occurred with a sub-threshold dose of pentagastrin and insulin stimulation in patients positive to insulin alone in the second hour after vagotomy, and in some of those insulin-negative patients submitted to the combined test.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sub-Threshold Doses of Pentagastrin on the Acid Response to Insulin in Duodenal Ulcer Subjects before and after Truncal Vagotomy

Elder

Gillespie

et al. 1972

Clinical Science

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1.On the basis of previously described dose-response curves, small doses of pentagastrin were infused in duodenal ulcer patients before and after vagotomy. No increase or decrease in gastric acid output was noted, confirming that the doses of pentagastrin used were sub-threshold.2. In twenty-six duodenal ulcer patients the effect of sub-threshold doses of pentagastrin on the insulin response resulted in three distinct patterns. (i) In subjects with clearly functioning vagal pathways, no increase in acid output occurred after insulin when a sub-threshold dose of pentagastrin was added; (ii) patients with equivocal acid responses to insulin alone showed augmentation of acid output when given insulin and a sub-threshold pentagastrin infusion; (iii) patients with no response to insulin after truncal vagotomy showed some increase in acid output to the combined agents, and in two patients, criteria for a clearly positive acid response were satisfied.3. We conclude from these studies that potentiation exists between insulin-induced cholinergic stimulation and infusion of sub-threshold doses of pentagastrin in man.

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Section: Discussionmentioning

confidence: 99%

The Effect of Sub-Threshold Doses of Pentagastrin on the Acid Response to Insulin in Duodenal Ulcer Subjects before and after Truncal Vagotomy

Elder

Gillespie

et al. 1972

Clinical Science

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“…Several studies published in recent years have now established that 0-2 U insulin/kg body weight provides an effective dose for stimulation of gastric acid secretion in subjects of the Western countries (Isenberg et al, 1969;Baron, 1970;Isenberg et al, 1970;Baron and Cowley, 1971;Baron et al, 1972;Cowley and Baron, 1973). However, in Indian subjects an effective dose of insulin to stimulate gastric secretion has not been established, although various studies of histamine stimulated gastric acid secretion have been reported (Vakil and Mulekar, 1965;Goyal et al, 1966;Desai et al, 1967;Desai et al, 1969).…”

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confidence: 99%

Histamine and insulin dose-response studies of gastric secretion in Indian control subjects and patients with duodenal ulcer in the Ganges delta

Jalan¹,

Mahalanabis²,

Maitra³

et al. 1978

Gut

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SUMMARY The gastric secretory responses to various doses of histamine and insulin have been studied in 11 control and 12 duodenal ulcer subjects belonging to the Ganges delta of India where the incidence of duodenal ulcer disease is known to be high. A dose of 0*04 mg/kg body weight of histamine acid phosphate was sufficient to produce peak gastric acid output both in the control and duodenal ulcer subjects. However, a dose as low as 0-025 U insulin/kg body weight was enough to produce peak rates of gastric acid output in duodenal ulcer subjects, whereas in the controls a minimum dose of 0 05 U insulin/kg body weight was sufficient. A greater proportion of the duodenal ulcer patients also showed a peak acid secretory response in the first hour after administration of insulin. Furthermore, increasing doses of insulin in this population did not produce lower levels of blood glucose but did produce increasingly high acid output as subjects do in the West. K values derived from the intravenous glucose tolerance test showed that 75% of duodenal ulcer patients and 54% of the controls had variable degrees of intolerance to glucose. Gastric acid secretion in response to a bolus of 50 ml 50% intravenous glucose was also studied in a separate group of 16 duodenal ulcer and 13 control subjects. A sharp rise in the volume, titratable acidity, and total acid output was observed in the early part of the fourth hour in the control and duodenal ulcer subjects. In a separate group of controls a bolus of intravenous hypertonic saline produced no such increase in gastric acid secretion.

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Pre- and Postoperative Secretory Tests

Emås¹

1974

Vagotomy

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The Effect of Graded Insulin Doses on Incompletely Vagotomized Subjects

Cited by 8 publications

References 8 publications

The Effect of Sub-Threshold Doses of Pentagastrin on the Acid Response to Insulin in Duodenal Ulcer Subjects before and after Truncal Vagotomy

The Effect of Sub-Threshold Doses of Pentagastrin on the Acid Response to Insulin in Duodenal Ulcer Subjects before and after Truncal Vagotomy

Histamine and insulin dose-response studies of gastric secretion in Indian control subjects and patients with duodenal ulcer in the Ganges delta

Pre- and Postoperative Secretory Tests

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