Effect in dogs of various portal vein shunts on response to insulin

¹ Department of Surgery and the Parmly Research Laboratory of the Department of Medicine, Northwestern University Medical School, Chicago, Illinois; and Departments of Surgery, University of Colorado Medical School and Denver Veterans Administration Hospital, Denver, Colorado

Surgical alterations of portal drainage patterns were made in dogs in order to determine the effect of redistribution of endogenous and injected insulin. With an Eck fistula, progressive diminution of hypoglycemic response to insulin was noted. With a reverse Eck fistula, the fall in venous blood sugar was comparable whether injection was given via the portal system or systemically. With portacaval transposition, in which the pancreatic drainage is diverted from the liver, no alterations in general health, fasting blood sugars, or insulin response were noted. The results are discussed in relation to recent concepts in which insulin is thought to regulate or be regulated by the liver.