THE PANCREATIC ALPHA AND BETA CELLS RESPONSES TO 1-ARGININE AND INSULIN-INDUCED HYPOGLYCAEMIA IN HYPERTHYROIDISM

Abstract

In order to assess the secretory capacity of the pancreatic alpha and beta cells in patients with hyperthyroidism, the plasma glucagon and insulin responses to 1-arginine and insulin-induced hypoglycaemia in 12 patients were compared with those in 6 normal subjects. The response of beta cell to hypoglycaemia was evaluated by measuring the decrease in plasma C-peptide immunoreactivity (CPR) level. There was a negligible rise in blood glucose and plasma insulin levels in the patients, whereas a significant increase occurred in normal subjects during the arginine infusion. Although no difference in the fasting plasma glucagon concentration between the two groups was found, 30 min after the beginning of the arginine infusion, the plasma glucagon levels rose to a peak of 252 ± 35 pg/ml in the patients, a value significantly lower than 387 ± 53 pg/ml in the normal subjects. The insulin-induced hypoglycaemia caused no significant difference in the peak values of plasma glucagon between the two groups. There was a significant fall in plasma CPR after the insulin injection in both groups but the per cent decrement was rather greater in the patients than in the normal subjects. These results suggest that the pancreatic alpha and beta cells in hyperthyroidism have a functional defect in response to 1-arginine but not to insulin-induced hypoglycaemia. The mechanism involved in these disorders is discussed.