[Changes in glucose metabolism and endocrine function in the remnant pancreas after major pancreatectomy, with special reference to the function of the anti-insulin system in Sandmeyer's diabetes (author's transl)].

Changes in glucose tolerance and the function of the anti-insulin system after a major resection of the canine pancreas were divided into three types. Immediately after the removal of 90 per cent or more of the pancreas, diabetes developed, and the function of the anti-insulin system was depressed, showing a poor response of glucagon secretion to hypoglycemia after insulin load and degeneration or destruction of the islet cells and both A and B cells, and the dosage of insulin required to control blood sugar was close to that of a total pancreatectomy. 6 to 24 weeks after the removal of 70 to 90 per cent of the pancreas, so-called Sandmeyer's diabetes occurred, in which glucose tolerance and the function of the anti-insulin system were within the normal range during the early postoperative periods, but the function of the anti-insulin system was highly activated later, showing a high response of pancreatic glucagon secretion to hypoglycemia after insulin load, accompanied by degeneration of B cells, but not A cells. These results could well explain the fact that the insulin dosage needed to control blood sugar in Sandmeyer's diabetes was 3 to 4 times more than it was in total pancreatectomy. After the removal of 70 per cent or less of the pancreas, diabetes did not occur, and glucose tolerance and the function of the anti-insulin system were maintained well, without any significant change in the islets of the remnant pancreas. Insulin therapy relieved the disturbed function of the anti-insulin system in diabetes following pancreatectomy.