Studies in five dogs with chronic pancreatic and gastric fistulae have shown that insulin-induced vagal stimulation of the pancreas (gastric fistula open) resulted in protein and bicarbonate outputs very much smaller than those obtained with a 400-g meat meal. However, when the insulin-activated gastric acid secretion was allowed access to the duodenum (gastric fistula closed) peak outputs of both bicarbonate and protein were observed which were closely similar to the response to the meal. These findings suggest that insulin-induced hypoglycaemia results in stimulation of the pancreas within the physiological range when gastric acid is allowed access to the duodenum with consequent release of secretin.
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