112: Insulinemia and intraduodenal milk infusion

Knowledge of intestinal stimulus to insulin release increase rapidly. However, the physiological role of the intestinein the glycoenergetic regulation is yet poorly understood. The consequences of intraduodenal milk infusion were therefore investigated. We performed duodenal intubation for diagnosis purpose in 11 children (l to 10 years) without pancreatic insufficiency, abnormal jejunal histology or diabetes. Under gastric aspiration, milk (Nutramigen)was infused in the 1st part of duodenum at a constant rate of 4 ml/min/m2. Simultaneous ly the serum concentration of glucose, insulin, FFA and gastrin were determined. During the first 30 minutes we observed a sharp increase in insulinemia (from 5.5 μU/ml ± 2.4 (x ± SEM) at time 0 to 24.3 ± 9.8 at 30 rain) a small increase in glucose concentration (from 73.4mg/ 100 ml ± 6.9 to 95.7 ± 13.3), a small decrease in FFA (from 594 ± 104 μeq/liter to 492 ± 157). After 30 minutes a plateau was achieved for glucose (95 mg/100 ml) and for insulin (25 μU/ml). In contrast FFA concentration was low (230 μeq/1 at 240 min). No change in gastrin concentration was observed. These results suggest that intraduodenal milk infusion stimulates insulin release. It appears that duodenum plays an important role in energetic homeostasis in normal children.