Plasma levels of glucagon-like polypeptides in gastrectomized patients transformed from Billroth II into Billroth I.

An oral glucose tolerance test (OGTT) has been performed in a group of patients with partial gastrectomy before and after transforming the anastomosis from Billroth type II (B II) into Billroth type I (B I). Glucose tolerance was normal in both groups. The statistically significant differences in blood glucose (BG) values observed at 30 min between B I and normals and at 30, 60 and 90 min between B II and normals occur without concomitant changes in insulin (IRI) plasma levels. In the course of the test a marked rise (statistically significant from 30 to 180 min) in glucagon-like immunoreactants (GLI) plasma levels was noted in B II patients and has been attributed to the rapid intestinal transit. Otherwise, the restoration of duodenal passage induced a clear decrease of GLI levels which returned to normal values. Increased immunoreactive glucagon (IRG) plasma levels in B II group do not seem to be due to cross-reactivity with GLI. The raised BG levels occurring in B II cannot be attributed either to a reduced insulin secretion or to an increase in biologically active components of glucagon.