LARRY B. BALLONOFF, M.D.; THOMAS J. HANSON, M.D.
To the editor: The paper by Kumar, Mehtalia and Miller (1) suggests that the insulin response to glucagon administration be used as a screening test in patients in whom "the clinical features suggest an insulinoma." We feel this test offers no advantage over the determination of plasma insulin and glucose after an overnight fast.
Pooling the data from this article and that of Marks and Samols (2), 20 of 21 patients had abnormal fasting insulins or amended insulin to glucose ratios (3) at the start of the glucagon tolerance test and thus did not require any further diagnostic study. Obesity,
BALLONOFF LB, HANSON TJ. Diagnosis of Insulinomas. Ann Intern Med. ;81:565–566. doi: 10.7326/0003-4819-81-4-565
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Published: Ann Intern Med. 1974;81(4):565-566.
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