Changes in insulin secretion after secretin administration and the implications in diabetes mellitus.

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Abstract
Secrepan (Eisai Co. Tokyo Japan) was administered to 9 healthy volunteers and 36 patients with non-insulin dependent diabetes mellitus (NIDDM) to clarify the effect of secretin on the pancreatic B-cell, by determining the changes in blood of insulin (IRI). Whereas IRI in healthy subjects showed a monophasic change, reaching a peak (.DELTA.IRI=43.+-.7.3 .mu.U/ml, M.+-.SE) 5 min after secretin loading and returning to the basal level in 15 min, NIDDM patients on diet therapy (.DELTA.IRI=40.2.+-.7.6 .mu.U/ml) showed no significant difference from the control group, but NIDDM patients on sulfonyurea (SU) (15.5.+-.2.4 .mu.U/ml) and those on insulin therapy (5.3.+-.1.4 .mu.U/ml), both showed a significant depression in responsiveness. Further, the changes in insulin secretion after atropine administration in healthy subjects and the changes in IRI response to Secrepan in vagotomized patients were also determined. As a result, data which preclude the possibility of association of the vagus nerve and cholinergic nerve with the stimulation of insulin secretion by secretin were obtained, and a direct action of secretin on the cell of islets of Langerhans was suggested. The maximum IRI response after a secretin load had a significant positive correlation with the IRI response after a 75-gm GTTand the content of C-peptide immunoreactivity in 24-hour urine. Therefore, insulin respone to a secretin load can be useful in assessing endogenous insulin secretion and provides a pertinent clincal guide for the selection of an appropriate therapy for diabetes mellitus.

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