Anomalous glucose and insulin responses in patients with insulinoma. Caveats for diagnosis

R. F. Dons, J. Hodge, B. H. Ginsberg, M. F. Brennan, Philip Cryer, I. A. Kourides, P. Gorden

Research output: Contribution to journalArticlepeer-review


Two patients with insulinomas had unusual glucose and insulin-secretory dynamics in response to prolonged fasting. In patient 1, low insulin values persisted throughout three separate supervised fasts without a steady rise in the insulin-glucose ratio. In patient 2, a rising insulin-glucose ratio during a fast returned to normal after a documented catecholamine surge following a transient hypoglycemic episode. While patient 1 had clearly elevated proinsulin values of 52% to 57%, patient 2 had a near-normal value of 23%. The diagnosis of an insulinoma can usually be made by obtaining simultaneous glucose and insulin values during a prolonged supervised fast. Rarely, however, anomalous results may be obtained during supervised fats of patients with insulinoma, and a broader range of diagnostic tests will be required to establish the correct diagnosis.

Original languageEnglish
Pages (from-to)1861-1862
Number of pages2
JournalArchives of Internal Medicine
Issue number10
StatePublished - Dec 1 1985


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