β-Cell function and insulin sensitivity in tropical calcific pancreatitis from North India

• Published in: Metabolism, clinical and experimental Vol. 46; no. 4; pp. 441 - 444
• Main Authors: Mehrotra, Rabindera N., Bhatia, Eesh, Choudhuri, Gourdas
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-1997; Elsevier
• Subjects: Biological and medical sciences; Blood Glucose - analysis; Chronic Disease; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Glucose Tolerance Test; Humans; India; Insulin - blood; Insulin Resistance; Islets of Langerhans - physiology; Medical sciences; Pancreatitis - physiopathology; Tropical medicine; Asia; India; Endocrinopathy; Human; Pancreatic hormone; Cell function; Pathophysiology; Pathogenesis; Pancreatitis; Insulin; Protein hormone; Target tissue resistance; Chronic; Sensitivity; B-Cell; Calcification; Digestive diseases; Cytopathology; Impaired glucose tolerance; Pancreatic disease
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/S0026-0495(97)90063-9

Tropical calcific pancreatitis (TCP) is a variant of chronic pancreatitis, occurring only in developing countries. It frequently leads to diabetes at a young age. To determine the pathogenesis of glucose intolerance, β-cell function and insulin sensitivity were measured in 11 TCP patients with normal glucose tolerance (TCP-NGT), six TCP patients with mild hyperglycemia [TCP-DM] median fasting plasma glucose, 6.1 mmol/L), and 16 healthy control subjects. The technique of continuous infusion of glucose with model assessment (CIGMA) was used to calculate β-cell function (%B) and insulin sensitivity (%S), based on plasma glucose and insulin levels achieved after an intravenous infusion of glucose. %S was similar in both groups of TCP patients and controls. In contrast, %B was significantly lower in TCP-DM patients (median, 53; interquartile range, 41 to 62) compared with controls (90; 65 to 143;
P < .01) and with TCP-NGT patients (119; 91 to 159;
P < .01). TCP-NGT and control subjects had similar β-cell function. Among patients with TCP, %B negatively correlated with the duration of pancreatitis (
r = −.63,
P < .05). Our results suggest that patients with TCP develop diabetes due to a diminution in beta-cell function, and that insulin resistance does not play a significant role in its pathogenesis.