Fig. 1 A: Effects of intramuscular injection of glucagon on the blood glucose levels (changes from basal, ƒ BG) as compared with effects of scopolamin
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2 Fig. 1 A: Effects of intramuscular injection of glucagon on the blood glucose levels (changes from basal, ƒ BG) as compared with effects of scopolamine butylbromide during upper gastrointestinal endoscopy. B: Effects of intramuscular injection of glucagon on ƒ BG of diabetic patients and non-diabetic subjects during upper gastrointestinal endoscopy. Data are mean }SD in each group. *: p<0.05, **: p<0.005 compared with scopolamine butylbromide group A and non-diabetic subjects B. (): number of subjects.
3 Fig. 2 A: Effects of intramuscular injection of glucagon on the immunoreactive insulin (IRI) levels as compared with effects of scopolamine butylbromide during upper gastrointestinal endoscopy. B: Effects of intramuscular injection of glucagon on the IRI levels of diabetic patients and non-diabetic sunjects during upper gastrointestinal endoscopy. Data are mean }SD in each group. *: p<0.05 compared with scopolamine butylbromide group A and non-diabetic subjects B. (): number of subjects. Fig. 3 A: Effects of intramuscular injection of glucagon on the growth hormone (GH) levels as compared with effects of scopolamine butylbromide during upper gastrointestinal endoscopy. B: Effects of intramuscular injection of glucagon on the GH levels of diabetic patients and non-diabetic subjects during upper gastrointestinal endoscopy. Data are mean }SD in each group. *: p<0.05 compared with scopolamine butylbromide group. (): number of subjects.
4 Fig. 4 Effects of intramuscular injection of glucagon on the adrenocorticotropic hormone (ACTH) levels as compared with effects of scopolamine butylbromide during upper gastrointestinal endoscopy. Data are mean }SD in each group. There is no statistical difference between effects of glucagon and scopolamine butylbromide. (): number of subiects.
5 1) Hradsky M, Stockbrugger R, Dotevall G (1974) The use of glucagon during upper gastrointestinal
6 endoscopy. Gastrointest endoscopy 20: 162 9) Chernish SM, Miller RE, Rosenak BO, Scholz NE (1972) Hypotonic Duodenography with the use of glucagon. Gastroenterol 63: ) Jungk K (1977) Colon-Doppelkontrastuntersu- mit Glukagon. Methodik und Resultate. chung Rontgen-Bl 30: 8-14
7 Abstract Endocrine and Metabolic Effects of Glucagon Used as a Premedication in Upper Gastrointestinal Endoscopy of Diabetic Patients Compared with Scopolamine Butylbromide \ \ Mikio Shiomi, Kikuko Kawabata, Kazuhito Kawabata and Norihiko Aoki The Second Depertment of Internal Medicine, Kinki University School of Medicine, Osakasayama, Osaka, Japan Endocrine and metabolic effects of glucagon as a premedication in endoscopic examinations of the upper gastrointestinal tract of diabetic patients were investigated. We measured the levels of blood glucose, immunoreactive insulin, growth hormone and adrenocorticotropic hormone after intramuscular injection of glucagon in the diabetic patients (n=7) and in non-diabetic subjects (n=10) before upper gastrointestinal endoscopy. Scopolamine butylbromide was used in a control study to evaluate and compare the effects of glucagon. The maximal increase in the levels of blood glucose after intramuscular injection was about 96 mg/dl from basal in the diabetic patients and 55mg/dl from basal in the non-diabetic subjects, and the increase after 120 minutes was 39.0mg/dl in diabetic patients and -2.1mg/dl in the nondiabetic subjects. However, there was no change in blood glucose levels after intramuscular injection of scopolamine butylbromide in both diabetic patients and non-diabetic subjects. Serum levels of immunoreactive insulin changed in parallel with the levels of blood glucose. There was a significant difference in the serum levels of growth hormone between glucagon and scopolamine butylbromide injections. There was no statistical difference in serum levels of adrenocorticotropic hormone between glucagon and scopolamine butylbromide injections. In one of ten non-diabetic subjects injected with glucagon, mild asymptomatic reactive hypoglycemia (41mg/dl) was observed but no therapy was required. No other untoward effects of glucagon were noted in either diabetic patients or non-diabetic subjects. Thus, glucagon can be safely used in diabetic patients as a premedicative drug for an endoscopic examination, especially in cases in which anticholinergic drugs are contraindicated. J. Japan Diab. Soc. 42 (12): 997 `1003, 1999
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