The effect of intragastric pH-variations on the gastric acid response to insulin hypoglycaemia in healthy subjects and duodenal ulcer patients
Stenquist, B.; Knutson, U.; Rehnberg, O.; Olbe, L.
Scandinavian Journal of Gastroenterology 12(2): 169-175
1977
ISSN/ISBN: 0036-5521 PMID: 15311 Document Number: 117119
The gastric acid response to i.v. injection of 0.15 units of soluble insulin/kg body wt was determined in healthy subjects and duodenal ulcer (DU) patients during intragastric perfusion with water, 0.1 M HCl and alkaline buffer (pH 8.3). Perfusion with hydrochloric acid significantly reduced the peak gastric acid output following insulin in 6 healthy subjects (reduction 45% P < 0.05), but had no significant effect on the peak gastric acid response to insulin in 7 DU patients (reduction 16%, P > 0.05). The 2.5 h gastric acid response to insulin was significantly reduced in both groups (56% and 35%, respectively) by exogenous acidification of the stomach. The gastric acid response to insulin hypoglycemia in 3 DU patients was the same with intragastric water and alkaline buffer perfusion. The reduction of the gastric acid response to insulin hypoglycemia by intragastric acidification corresponded to a reduced volume secretion and could not be ascribed to increased back diffusion of H+ or duodenal inhibition. The gastric acid response to insulin hypoglycemia is inhibited by a low intragastric pH in man, and DU patients are less sensitive to the inhibitory mechanism than healthy subjects.