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Target Concepts:
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Query: UNIPROT:P01275 (
glucagon
)
26,492
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Glucagon
has been claimed to be an effective treatment for pancreatitis, but the studies reporting this were either uncontrolled or did not use concurrent controls, and none were double blind. To evaluate the efficacy of
glucagon
for alcohol-related pancreatitis, we performed a controlled, randomized, double blind study. Twenty-six patients with pancreatitis associated with alcohol ingestion received either
glucagon
or placebo in addition to intravenous fluids, nasogastric suction, and meperidine as needed. There were no statistically significant differences between the group which received
glucagon
and the group which did not in any of 12 parameters which included symptoms, signs, laboratory tests, and requests for analgesia. We conclude that
glucagon
in addition to conventional therapy is no better for the treatment of
alcoholic pancreatitis
than conventional therapy alone.
...
PMID:Failure of glucagon in the treatment of alcoholic pancreatitis. 34 25
Enteropeptidase, trypsin, and chymotrypsin activity in basal and secretin-stimulated duodenal juice of 20 normal adult volunteers and 15 patients with gastrotestinal disease were determined. All enzyme concentrations showed skew distributions, but fluctuations in the secretin-stimulated juices were less pronouced than in the basal secretions. Secretin administration had no influence on the release of enteropeptidase from human duodenal mucosa, but resulted in a very small increase in secretion of pancreatic enzymes. Six out of seven patients with chronic
alcoholic pancreatitis
or cancer of the pancreas exhibited highly significant elevations of enteropeptidase in their basal as well as secretin-stimulated duodenal juice. It is suggested that raised luminal enteropeptidase activity may be the result of pancreatic insufficiency or elevated blood
glucagon
concentrations.
...
PMID:Enteropeptidase levels in duodenal juice of normal subjects and patients with gastrointestinal disease. 66 28
Thirty patients suffering from chronic
alcoholic pancreatitis
(18 calcified) were entered into a study of exocrine and endocrine pancreatic function based on two maximal stimulation tests, namely the secretin-cerulein test and the
glucagon
test with serum assays of C peptide. The
glucagon
test was also performed in 19 control subjects. In addition, 10 chronic pancreatitis patients and nine controls were subjected to an oral glucose tolerance test (OGTT) with serum insulin determinations. C peptide basal values were decreased only in patients with severe pancreatic exocrine insufficiency (P less than 0.001), while delta C peptide values were also reduced in patients with moderate exocrine insufficiency (P less than 0.001). Lipase output correlated very well with delta C peptide values (P less than 0.001). While serum insulin levels during OGTT and C peptide basal values showed no significant differences between the chronic pancreatitis and control groups, delta C peptide values were significantly reduced in chronic pancreatitis patients (P less than 0.02). Both endocrine and exocrine function are impaired in chronic pancreatitis, as demonstrated by maximal tests, even in early stages of the disease.
...
PMID:Exocrine and endocrine functional reserve in the course of chronic pancreatitis as studied by maximal stimulation tests. 172 34
Reported are eight patients with idiopathic chronic pancreatitis and two patients with
alcoholic pancreatitis
who had near total distal pancreatectomy for disabling pain and underwent simultaneous segmental pancreatic autotransplantation of the body and tail of the gland to the femoral area in an attempt to prevent or delay the onset of diabetes. The median follow-up period was 31 months, and follow-up study in nine patients ranged from 24 to 54 months. Patency of the grafts was determined by angiography and selected percutaneous venous assays for insulin. Islet cell function was determined by oral glucose tolerance tests, intravenous (I.V.) glucose tolerance tests, and I.V.
glucagon
stimulation studies. Segmental autotransplantation was technically successful in eight patients, only one of whom required insulin (at 2 years after grafting). The other seven patients with technically successful grafts have remained insulin independent, including two patients who later underwent pyloric preserving pancreatoduodenectomy for completion pancreatectomy. Variable pain relief was observed in patients who underwent near total pancreatectomy, but pain was unrelieved in those patients who underwent limited distal resection. Patients with idiopathic pancreatitis appear to have better pain relief and preservation of endocrine function than alcoholic patients. Segmental pancreatic autotransplantation prevents or delays the onset of diabetes mellitus and should be considered as an alternative for those patients who require extensive pancreatic resection for chronic pancreatitis.
...
PMID:Segmental pancreatic autotransplantation with pancreatic ductal occlusion after near total or total pancreatic resection for chronic pancreatitis. Results at 5- to 54-month follow-up evaluation. 352 8
Nasogastric suction,
glucagon
, and cimetidine are proposed treatments for human acute pancreatic because they may reduce gastric acid and exocrine pancreatic secretion. However, the functional status of gastric and pancreatic secretion during human acute pancreatitis is unknown. Thus, we compared the effects of nasogastric suction, intravenous
glucagon
(5 microgram/kg per hour), and cimetidine (2 mg/kg per hour) on the output of acid and pancreatic enzymes and the clinical course of human acute pancreatitis. In three subjects with acute
alcoholic pancreatitis
, gastric acid secretion was increased above normal and was decreased by
glucagon
and cimetidine used alone and in combination. In two of the three patients, duodenal output of trypsin and lipase was normal or increased and was reduced by
glucagon
and cimetidine given alone or in combination. Twenty patients with documented acute pancreatitis randomly received treatment with nasogastric suction, cimetidine alone, or the combination of cimetidine and
glucagon
. Four of the five complications observed during the trial occurred in the combination-treatment group (P less than 0.05). Administration of cimetidine alone or with
glucagon
did not improve the outcome when compared with nasogastric suction.
...
PMID:A prospective study of the antisecretory and therapeutic effects of cimetidine and glucagon in human acute pancreatitis. 702 37
Chronic
alcoholic pancreatitis
(CAP) is often complicated by the onset of diabetes mellitus. The aim of this study was to assess the residual beta cell function (evaluated by means of the
glucagon
test) and the mean disposal rate of insulin (with the insulin tolerance test) in 66 CAP patients with or without abnormalities of glucose metabolism and in 19 control subjects. On the basis of our data, we conclude that the glucose metabolism abnormalities in chronic pancreatitis occurs as a result not merely of impaired production of endogenous insulin, but also as result of a combination of the latter together with insulin resistance.
...
PMID:Diabetes in chronic alcoholic pancreatitis. Role of residual beta cell function and insulin resistance. 844 82
Diabetes mellitus (DM) in chronic pancreatitis (ChP) is considered a unique clinical and metabolic unit. Compared to type I DM it has many different properties: glycemic lability, more frequent hypoglycaemic episodes, and minimum incidence of ketoacidosis. The need of insulin administration to achieve satisfying diabetes mellitus compensation is significantly lower and response of peripheral tissues to endogenous and exogenous insulin significantly higher compared to type I diabetics. These clinical differences result from decreased but always preserved insulin secretion, decreased
glucagon
production, impaired external pancreatic secretion, and also excessive alcohol use or insufficient or irregular food intake of the patients. Secondary DM in ChP is accompanied by chronic, microangiopathic and neuropathic complications analogous to other DM types. Nonpharmacological treatment measurements of the first choice are elimination of alcohol, sufficient and adequate nutrition, and simultaneous treatment of impaired exocrinal secretion. A pharmacology treatment is insulin therapy! It is a substitution treatment for insulin deficiency. Insulin doses must be chosen very carefully because of the risk of hypoglycaemia. The most frequent cause of secondary diabetes mellitus in patients with pancreatic diseases in Europe is chronic
alcoholic pancreatitis
and in tropical countries and India non-alcoholic tropical calcific pancreatitis (TCP).
...
PMID:[Diabetes mellitus in chronic pancreatitis]. 1530 35