Impaired response of human pancreatic polypeptide to insulin-induced hypoglycemia in chronic pancreatitis without diabetes mellitus.

In order to clarify the pancreatic endocrine functions in mild chronic pancreatitis, the response of insulin to oral glucose load and the response of glucagon and human pancreatic polypeptide (HPP) to insulin-induced hypoglycemia were investigated in five normal controls and eight patients with chronic pancreatitis but without diabetes mellitus. Although insulin and glucagon responses in patients with chronic pancreatitis tended to be lower than those in normal subjects, the differences between the two groups were not statistically significant. In contrast, HPP response to hypoglycemia in the patients was markedly impaired and significantly lower than that in normals (p less than 0.02). This finding indicates that the impairment of HP response is the earliest and most definite manifestation among pancreatic endocrine abnormalities in chronic pancreatitis.