F. JOHN SERVICE, M.D.
To the editor: In a recent issue, Reynolds and colleagues (1) reported the case of a patient with an insulinoma in which a computerized euglycemic glucose clamp was used as a diagnostic procedure to assess C-peptide suppression. Reduced C-peptide suppressibility to insulin-induced hypoglycemia is a well-documented feature of insulinomas. Hyperinsulinemia concurrent with euglycemia, the conditions of the clamp used by these authors, probably suppresses C-peptide to a small extent in healthy persons (2), but this effect has not been seen by all investigators (3). The effect of hyperinsulinemia alone on C-peptide suppression in insulinomas is unknown. The conclusion by Reynolds
SERVICE FJ. Diagnosis of Insulinoma and the Euglycemic Hyperinsulinemic Clamp Technique. Ann Intern Med. ;102:417–418. doi: 10.7326/0003-4819-102-3-417
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Published: Ann Intern Med. 1985;102(3):417-418.
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