The behaviour of insulinaemia in patients ith liver cirrhosis after intravenous administration of glucose, tolbutamide and glucagon.

Abstract

The response of both blood glucose and serum immunoreactive insulin to glucagon, glucose and tolbutamide was studied in ten patients with welldocumented, advanced liver cirrhosis and in ten healthy subjects without history indicative of liver impairment or diabetes. Glucose was administered as a rapid intravenous injection in a dose of 0.33 g/kg of body weight, tolbutamide in a dose of 1.0 g and glucagon in a dose of 1.0 mg. The mean fasting serum insulin levels of cirrhotic patients did not differ significantly from the values obtained in healthy subjects. However, after administration of glucose or tolbutamide the rise of insulinaemia was significantly higher in cases of liver cirrhosis than in normal subjects. The increase of serum insulin values after intravenous administration of glucagon was similar in both groups; thus glucagon failed to induce hyperinsulinaemia as observed after glucose or tolbutamide. The possible causes of this phenomenon have been discused.