Insulin Response and Portal-Peripheral Insulin Difference during the Oral Glucose Tolerance Test in Patients after Abdominal Operations

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Abstract
Following abdominal surgery, insulin and glucose concentrations in the portal vein and in a peripheral vein are compared in patients during control periods and after oral administration of glucose. During the control period, the glucose concentrations are identical in both veins. After glucose loads, with the prompt increase of portal glucose concentration, the portal-peripheral difference also increases (P < 0.01). During the control period the insulin concentration in the portal vein is double as compared to peripheral blood (P < 0.005). After glucose load the increasing portal insulin and the peripheral and portal glucose correlate with the portal-peripheral insulin difference (P < 0.001). There is a significant positive correlation between the peripheral glucose area as a parameter of glucose tolerance and the portal insulin area as a semiquantitative parameter of insulin secretory capacity (P < 0.001). In the early postoperative period in patients with a diminished oral glucose tolerance (large glucose areas) there is an even greater insulin response in comparison to patients with normal oral glucose tolerance. In those patients with diminished glucose tolerance, the insulin response is essentially delayed.