1990 Fiscal Year Final Research Report Summary
Metabolic and Nutritional Management after Total Pancreatectomy and Study on Nasal Absorption of Glucagon.
| Project/Area Number |
01570761
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kumamoto University |
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Principal Investigator |
IKEI Satoshi Kumamoto University. Medical School Assistant, 医学部, 助手 (90136705)
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| Co-Investigator(Kenkyū-buntansha) |
YAMANE Takaaki Kumamoto University. Medical School Assistant Kumamoto University Hospital, 医学部, 助手 (20210502)
SAKAMOTO Kiyoshi Kumamoto University. Medical School Assistant, 医学部, 助手 (10162306)
MORI Katutaka Kumamoto University. Medical School Professor College of Medical Science, 医療技術短期大学部, 教授 (10040213)
NAKANO Masahiro Kumamoto University. Medical School Professor Kumamoto University Hospital, 医学部附属病院, 教授 (40002125)
HIROTA Masahiko Kumamoto University. Medical School Resident Kumamoto University Hospital
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| Project Period (FY) |
1989 – 1990
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| Keywords | total pancreatectomy / glucagon / blood glucose control / metabolic management / glucagon aerosol / nasal absorption / 脂肪肝 / 高アンモニア血症 |
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| Research Abstract |
The management in which both insuli and glucagon in addition to insulin alone resulted in fairly stable blood glucose control with the administration of an adequate level of energy in total pancreatectomized patients. This method should thus promote both recovery from postoperative stress and healing of the surgical wound. The effects of exogenous glucagon on a totally pancreatectomized patient were evaluated in both the acute postoperative and convalescent periods.
In the acute postoperative phase, glucagon stabilized the blood glucose level and allowed the administration of an adequate amount of energy, while during the convalescent period, it proved useful in promoting the metabolism of lipids and amino acids and maintaining liver function. Moreover, we developed a glucagon aerosol which enabled frequent administration without causing major discomfort to the patient and raised the blood glucagon to satisfactory level.
Thus, liver function and the metabolism of carbohydrates, lipids, a
… More
nd amino acids improved with the administration of glucagon. However, because the duration of the action of glucagon is so short. daily administration only results in the reappearance of metabolic disturbances. It is therefore necessary to develop a long acting glucagon preparation or a method for frequent administration that dose not cause discomfort to the patient. The use of a nasal spray resulted in a decrease in the absorption of glucagon to less than one-third of the same dose given subcutaneously, moreover, the amount absorbed intranasally can vary. In insulin administration regulation of the amount absorbed is needed due to the long duration of action. Whereas, because this is not needed for glucagon due to its short duration of action, a nasal spray is suitable.
Nasal absorption of glucagon in rats was enhanced by addition of sodium glycyrrhetinate (GA Na), dipotassium glycyrrhizinate (GZ K_2), and carbeboxolone (glycyrrhetinic acid hydrogen succinate) disodium salt (GAHS Na_2). The latter agent was the most effective. GAHS Na_2 is a very useful promoter which dose not irritate the nasal mucosal membrane or degrade glucagon. Less
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