Insulin-stimulated gastric acid secretion after vagotomy in man

The gastric acid response to insulin was studied in a group of patients who had had incomplete truncal vagotomies and in 22 patients with complete vagotomies. A dose-response study of gastric acid secretion after insulin in 17 patients with incomplete vagotomy indicated that a dose of 0.2 unit/kg was greatly superior to 0.4 unit/kg and marginally superior to 0.1 unit/kg in eliciting the highest acid response. Eight “early” responders had a significantly greater peak acid output after insulin, 0.2 unit/kg, than 9 “late” responders, but only 1 early responder developed a recurrent ulcer compared with 4 patients in the late group. The timing of a patient's positive Hollander response to insulin was not related to the optimum dose of insulin in that patient. The blood glucose response to insulin, 0.2 unit/kg, was unchanged after complete vagotomy. The changes of blood glucose after a given dose of insulin varied from one individual to another. This variation could account for the fact that the dose which produced highest peak acid output in some individuals was 0.1 unit/kg and in others 0.2 unit/kg.