Suppression of Extrapancreatic Glucagon by Octreotide May Reduce the Fasting and Postprandial Glucose Levels in a Diabetic Patient after Total Pancreatectomy

Hideyuki Okuma; Ryotaro Bouchi; Seizaburo Masuda; Takato Takeuchi; Masanori Murakami; Isao Minami; Hajime Izumiyama; Koshi Hashimoto; Takanobu Yoshimoto; Yoshihiro Ogawa

doi:10.2169/internalmedicine.8963-17

CASE REPORTS

Suppression of Extrapancreatic Glucagon by Octreotide May Reduce the Fasting and Postprandial Glucose Levels in a Diabetic Patient after Total Pancreatectomy

Hideyuki Okuma, Ryotaro Bouchi, Seizaburo Masuda, Takato Takeuchi, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa

Author information

Hideyuki Okuma
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Ryotaro Bouchi
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Seizaburo Masuda
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Takato Takeuchi
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Masanori Murakami
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Isao Minami
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Hajime Izumiyama
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University, Japan
Koshi Hashimoto
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Takanobu Yoshimoto
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
Yoshihiro Ogawa
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan

Keywords: octreotide, glucagon, hypoglycemia, sensor augmented pump, total pancreatectomy

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 22 Pages 3061-3066

DOI https://doi.org/10.2169/internalmedicine.8963-17

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Abstract

A 52-year-old woman was treated with sensor augmented pump therapy after undergoing total pancreatectomy for a nonfunctional pancreatic neuroendocrine tumor (NET). The secretion of both endogenous insulin and pancreatic glucagon were completely depleted. Octreotide long acting repeatable (Oct-LAR) was administered for the treatment of liver metastasis of NET. Both the fasting and postprandial glucagon levels decreased immediately after the administration of Oct-LAR. In a continuous glucose monitoring analysis, episodes of nocturnal hypoglycemia was found to increase and an improvement of postprandial hyperglycemia was observed. This case suggests that octreotide may reduce the glucose level in both the fasting and postprandial states, in part by the suppression of extrapancreatic glucagon.

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