Carbohydrate metabolism and endocrine function in the pancreas remnant after major pancreatic resection.

Changes in glucose tolerance, in secretion of pancreatic hormones and in the islets of the pancreas were investigated after major resection of the pancreas in dogs to elucidate the pathophysiologic features of carbohydrate metabolism and the difference in the amount of insulin required in diabetes after total and partial pancreatectomy. In diabetes after 90 percent or more pancreatectomy, both insulin secretion and the function of the anti-insulin system decreased, associated with degeneration of the islet B, A, and D cells. The required insulin amount was similar to that needed after total pancreatectomy. Diabetes developed more than 6 weeks after 70 to 90 percent pancreatectomy, and insulin secretion decreased but the function of the anti-insulin system was accentuated with an increase in plasma glucagon levels, associated with degeneration in B cells but not in A and D cells. The amount of insulin required was 3 to 4 times greater than that needed after total pancreatectomy.