Document Detail

Assessment of suspected insulinoma by 48-hour fasting test: a retrospective monocentric study of 23 cases.
MedLine Citation:
PMID:  17611903     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Insulinoma causes fasting hypoglycaemia due to inappropriate insulin secretion. The diagnosis of insulinoma is based on Whipple's triad during a supervised fasting test. The aim of our study was to evaluate retrospectively the percentage of positive 48-hour fasting tests in a large series of patients with insulinoma.
DESIGN, PATIENTS AND METHODS: In a retrospective study, we identified 39 patients (24 females, 15 men; average age 47 years [range 12-78 years]) with insulinoma. Sixteen patients were diagnosed by spontaneous hypoglycaemia. Twenty-three patients with insulinoma were tested with a 48-hour fasting test and compared to 31 healthy controls who had a negative fasting test and were followed up for at least two years.
RESULTS: The fast was terminated due to neuroglycopenic symptoms in 4 patients (17.4%) at the 12th hour, in 17 patients (73.9%) at the 24th hour, and in 22 patients (95.7%) at the 48th hour. One patient with insulinoma had no neuroglycopenic symptoms, but was diagnosed by glucose and insulin levels during the 48-hour fast. Healthy controls had significantly higher blood glucose and lower insulin levels, and a lower insulin-glucose ratio than patients with insulinoma at the end of the fast.
CONCLUSIONS: In conclusion, the 48-hour fasting test was successful in the diagnosis of insulinoma in 95.7% of patients. In this series we did not observe a need for fasting beyond 48 hours.
M Quinkler; F Strelow; M Pirlich; W Rohde; H Biering; H Lochs; H Gerl; C J Strasburger; M Ventz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme     Volume:  39     ISSN:  0018-5043     ISO Abbreviation:  Horm. Metab. Res.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-05     Completed Date:  2007-09-27     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  0177722     Medline TA:  Horm Metab Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  507-10     Citation Subset:  IM    
Clinical Endocrinology, Internal Medicine Center for Gastroenterology, Hepatology, and Endocrinology, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
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MeSH Terms
Blood Glucose
Fasting / physiology*
Insulin / blood
Insulinoma / diagnosis*
Middle Aged
Retrospective Studies
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin

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