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GLUCAGON‐STIMULATED PLASMA C‐PEPTIDE AND INSULIN LEVELS IN ACTIVE AND NON‐ACTIVE ACROMEGALICS

The glucagon‐stimulated insulin and C‐peptide release in patients with active acromegaly, cured acromegalic patients and healthy controls were studied. There was an elevation of the fasting insulin levels in active acromegalics and the fasting C‐peptide levels in both patient groups. After i.v. injection of glucagon the insulin and C‐peptide levels increased. The highest levels were recorded in active acromegalics, but cured patients also had higher levels than the control group. The insulin/C‐peptide ratio was increased in active acromegalics in comparison with that found for inactive acromegalics and normal controls. In addition, the plasma half‐lives (T1/2) of endogenous insulin and C‐peptide were measured. It was found that the T1/2 for insulin was increased in active acromegalics only. From this study we conclude that even when the treatment of acromegaly is effective insulin and C‐peptide secretion do not normalize due, probably, to increased synthesis and release upon stimulation of the pancreatic β‐cells. In active acromegaly the removal of insulin is probably also reduced.