Use of Somatostatin and Somatostatin Analogs in a Patient with a Glucagonoma

Publisher Website
Google Scholar
Abstract
The effects of somatostatin (SRIF) and, for the first time in man, three of its analogs were studied in a patient with a glucagonoma. Circulating levels of glucagon were greater than 50 ng/ml (normal, 8; D-Cys14; and D-Trp8, D-Cys14) were equally effective in suppressing glucagon. All also caused a fall in insulin secretion, although at low doses [D-Trp8, D-Cys14]SRIF was relatively glucagon specific. The fall in glucagon produced by SRIF and two of the three analogs was accompanied by a fall in blood glucose. Interestingly, [D-Cys14]SRIF had no effect on blood glucose despite its potent effect on glucagon. During infusions, the patient noted a decrease in nausea and diarrhea, but no improvement in skin rash. Upon cessation of the infusions, there was a marked rebound, with glucagon levels of up to 400 ng/ml and an exacerbation of the gastrointestinal symptoms. These studies suggest that SRIF and its analogs all effectively lower glucagon levels. Although none is totally specific, [D-Trp8, D-Cys14]SRIF shows relative specificity at low doses. Glucagon synthesis is probably not inhibited, leading to a marked rebound after therapy. The gastrointestinal symptoms correlate well with the level of glucagon. Finally, based on the results with [DCys14] SRIF, the effect of SRIF on blood glucose, at least in this setting, appears to be independent of its effect on glucagon.

This publication has 2 references indexed in Scilit: