J.Jpn. Surg. Soc.. 124(2): 177-182, 2023

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Feature topic

BLOOD GLUCOSE MANAGEMENT AFTER TOTAL PANCREATECTOMY

Pancreatogenic diabetes is inevitable after total pancreatectomy due to the loss of pancreatic endocrine function. The loss of not only insulin, which has a hypoglycemic effect, but also of glucagon, which has a hyperglycemic effect, results in wildly fluctuating blood glucose levels that are difficult to manage. Recently, insulin analogues, rapid-acting insulin, and long-acting insulin have been introduced into clinical practice, and intensive insulin therapy has been used to control blood glucose levels, reducing the frequency of hypoglycemic attacks, but these therapies are still not satisfactory. Further development of tissue glucose sensors and insulin pumps led to the development of sensor-augmented pump (SAP) therapy. This therapy functions as a portable artificial pancreas, and we believe that this method will further improve glycemic control after total pancreatectomy. A prospective clinical study in patients after total pancreatectomy has been initiated, and its efficacy will be demonstrated in the near future.

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