Hypoinsulinemia in alcoholics with minimal liver disease

Abstract

The chronic pancreatitis (CP) may evolve with low insulin levels and develop clinical picture of diabetes mellitus. Low seric levels of insulin and C peptide after stimulus has also been described in asymptomatic alcoholics even with normal glycemic curves. It is known that the chronic alcoholism is the main etiological factor of CP and hepatic diseases, and that the insulin produced by the pancreas is metabolized mainly by the liver. High levels of periferic insulin are described in hepatic cirrhosis due to decrease of hepatic metabolization alone or associated to increase of periferic resistance. In alcoholics with minimal hepatic lesions to evaluate the seric insulin and glucose levels after stimulus with intravenous glucose. In 8 alcoholic patients with minimal hepatic lesions characterized by hepatic biopsy, and 26 non-alcoholics, healthy controls, it was studied the serum glucose and insulin levels in basal time, 1, 3, 5, and 10 minutes after stimulus with intravenous glucose (0.5 g/kg). The insulin means in time 1, 3 minutes and total integrated response after stimulus were lower (p < 0.05) in alcoholic group than in control, even with normal glucose curves. Alcoholics with minimal hepatic lesions showed low seric insulin levels after glucose stimulus, similar to former observations in asymptomatic alcoholics, indicating hypofunction of pancreatic B cells.