Plasma Concentrations of Islet Amyloid Polypeptide After Glucagon Administration in Type 2 Diabetic Patients and Non‐diabetic Subjects

Islet amyloid polypeptide (IAPP) is the main constituent of pancreatic islet amyloid, observed in the pancreases from patients with Type 2 diabetes mellitus. IAPP is synthesized by the pancreatic β‐cells. In order to study the secretion characteristics of IAPP in Type 2 diabetes mellitus, plasma IAPP was measured during a provocation test with glucagon in 33 Type 2 diabetic patients and 18 non‐diabetic subjects. The median fasting IAPP level was 5.7 (range 1.1–13.1) pmol l⁻¹ in the 27 patients treated with oral hypoglycaemic agents and 2.7 (1.9–5.9) in the 6 patients on insulin. In the non‐diabetic group fasting IAPP was 5.7 (2.2–10.1). Six minutes after glucagon administration median IAPP rose to 9.4 (1.7–31.0) and 6.1 (5.1–10.2) in the respective diabetic groups, and to 16.8 (4.0–41.0) in the non‐diabetic subjects (p 0.05). The correlation coefficient between change in IAPP and change in C‐peptide was 0.68 in the diabetic group. We conclude that intravenous administration of glucagon stimulates IAPP release from the β‐cell. This provocation test is easy to perform and can be used on a large scale in the study of IAPP secretion in Type 2 diabetes mellitus. 1993 Diabetes UK