Use of a Computerized Glucose Clamp Technique to Diagnose an Insulinoma
Authors: JOHN H. REYNOLDS
Journal: Annals of Internal Medicine (1984)

Brief Reports1 November 1984Use of a Computerized Glucose Clamp Technique to Diagnose an InsulinomaJOHN H. REYNOLDS, M.D., NEIL I. KAMINSKY, M.D., DAVID S. SCHADE, M.D., R. PHILIP EATON, M.D.JOHN H. REYNOLDS, M.D.Search for more papers by this author, NEIL I. KAMINSKY, M.D.Search for more papers by this author, DAVID S. SCHADE, M.D.Search for more papers by this author, R. PHILIP EATON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-5-648 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn insulinoma may be difficult to diagnose when roentgenograms and hormonal test results, such as with proinsulin, are normal. Autonomous insulin secretion is characteristic of this tumor, but administration of exogenous insulin to test for autonomy may cause severe hypoglycemia. The euglycemic glucose clamp technique is a research method that has not yet been applied to clinical medicine (1). With the aid of a minicomputer, we used this technique to safely detect autonomous insulin secretion in a patient susceptible to hypoglycemic seizures. After autonomous insulin secretion was documented, a laparotomy showed a 1.5-cm-diameter insulinoma. Surgical removal of the tumor resulted...References1. PACINI G, FINEGOOD D, and BERGMAN R. A minimal-model-based glucose clamp yielding insulin sensitivity independent of glycemia. Diabetes. 1982;31(5 pt 1):432-41. CrossrefMedlineGoogle Scholar2. TURNER R and HEDING L. Plasma proinsulin, C-peptide and insulin in diagnostic suppression tests for insulinomas. Diabetologia. 1977;13:571-7. CrossrefMedlineGoogle Scholar3. FAJANS S, FLOYD J, THIFFAULT C, KNOPF R, HARRISON T, and CONN J. Further studies on diazoxide suppression of insulin release from abnormal and normal islet tissue in man. Ann NY Acad Sci. 1968;150:261-80. CrossrefMedlineGoogle Scholar4. SERVICE F, HORWITZ D, and RUBENSTEIN A. C-peptide suppression test for insulinoma. J Lab Clin Med. 1977;90:180-6. MedlineGoogle Scholar5. HORWITZ D, RUBENSTEIN A, REYNOLDS C, MOLNAR G, and YANAIHARA N. Prolonged suppression of insulin release by insulin-induced hypoglycemia: demonstration by C-peptide assay. Horm Metab Res. 1975;7:449-52. CrossrefMedlineGoogle Scholar6. RUBENSTEIN A, CLARK J, MELANI F, and STEINER D. Secretion of proinsulin and C-peptide by pancreatic β cells and its circulation in blood. Nature. 1969;224:697-9. CrossrefGoogle Scholar7. LILJENQUIST J, HORWITZ D, JENNINGS A, CHIASSON J, KELLER U, and RUBENSTEIN A. Inhibition of insulin secretion by exogenous insulin in normal man as demonstrated by C-peptide assay. Diabetes. 1978;27:563-70. CrossrefMedlineGoogle Scholar8. ELAHI D, NAGULESPARAN M, and HERSHCOPF R. Feedback inhibition of insulin secretion by insulin: relation to the hyperinsulinemia of obesity. N Engl J Med. 1982;306:1196-202. CrossrefMedlineGoogle Scholar9. PONTIROLI A, SECCHI A, and DABANDI M. Study of hypoglycemic patients by the glucose clamp technique using the artificial pancreas. J Clin Endocrinol Metab. 1983;57:1297-300. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOHN H. REYNOLDS, M.D.; NEIL I. KAMINSKY, M.D.; DAVID S. SCHADE, M.D.; R. PHILIP EATON, M.D.Affiliations: University of New Mexico School of Medicine and Albuquerque Endocrinology Consultants P.A.; Albuquerque, New Mexico PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byInsulin Responses to Selective Arterial Calcium Infusion under Hyperinsulinemic Euglycemic Glucose Clamps: Case Studies in Adult Nesidioblastosis and Childhood InsulinomaArtificial pancreas in the diagnosis and treatment of insulinoma: a report of five casesSuppression of endogenous insulin secretion by exogenous insulin in patients with insulinomaBASREP: a method for maintaining euglycemia during somatostatin suppression of pancreatic secretionC-Peptide suppression test and recurrent insulinomaUse of euglycaemic clamping in evaluation of diazoxide treatment of insulinomaHypoglycemiaOscillations enhance the efficiency and stability of glucose disposalDiagnosis of Insulinoma and the Euglycemic Hyperinsulinemic Clamp TechniqueF. JOHN SERVICE, M.D. 1 November 1984Volume 101, Issue 5Page: 648-649KeywordsComputersEpileptic seizuresGlucoseHospital medicineHypoglycemiaHypoglycemicsInsulin secretionInsulinomaLaparotomy ePublished: 1 December 2008 Issue Published: 1 November 1984 PDF downloadLoading ...