DINESH KUMAR, M.D.; SURESH D. MEHTALIA, M.D.; LEONA V. MILLER, M.D.
▸Address reprint requests to Leona V. Miller, M.D., Chief, Diabetes Section, Los Angeles County University of Southern California Medical Center, Los Angeles, CA 90033.
KUMAR D., MEHTALIA S., MILLER L.; Diagnostic Use of Glucagon-Induced Insulin Response: Studies in Patients with Insulinoma or Other Hypoglycemic Conditions. Ann Intern Med. 1974;80:697-701. doi: 10.7326/0003-4819-80-6-697
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Published: Ann Intern Med. 1974;80(6):697-701.
The intravenous glucagon stimulation test was assessed as a diagnostic tool in the differential diagnosis of hypoglycemia. Six of seven patients with insulinoma had peak insulin values over 130 µU/ml. None of the controls with normal weight or patients with hypoglycemia as a result of other causes had a peak insulin value over 98 µU/ml. In this study and in glucagon tests done by other investigators, the peak insulin responses occurred from 3 to 30 minutes after injection of glucagon. Since this peak is highly transient it may be missed unless sampling is done every 5 minutes for at least 30 minutes. When done properly, this test was positive in over 80% of insulinoma patients. False-negative results occur in patients treated with diazoxide, hydrochlorothiazide, or diphenylhydantoin. False-positive tests may be seen in individuals who are obese or treated with tolbutamide.
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Cardiology, Endocrine and Metabolism, Gastroenterology/Hepatology, Hematology/Oncology, Diabetes.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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