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Diagnostic Use of Glucagon-Induced Insulin Response: Studies in Patients with Insulinoma or Other Hypoglycemic Conditions

DINESH KUMAR, M.D.; SURESH D. MEHTALIA, M.D.; and LEONA V. MILLER, M.D.
[+] Article and Author Information

▸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.


Los Angeles, California


Ann Intern Med. 1974;80(6):697-701. doi:10.7326/0003-4819-80-6-697
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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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