Carbohydrate Tolerance and Insulin Responses in Obstructive Jaundice

Twenty-three patients with obstructive jaundice were given a 50-g oral glucose tolerance test (G.T.T.) and an insulin stimulation test with oral glucose and intravenous tolbutamide and glucagon. An abnormal glucose response was as common in patients with carcinoma of the pancreas (seven out of 12) as in patients with “other” causes of obstructive jaundice (six out of 11). Though both groups had a low and delayed insulin response the insulin levels were significantly lower in patients with carcinoma of the pancreas. After the insulin stimulation test patients with obstructive jaundice who did not have carcinoma of the pancreas had a greater and significantly different insulin response from patients with pancreatic cancer. There was, however, considerable overlapping between the results of individual patients in the two groups.