Diagnosis of Insulinoma and the Euglycemic Hyperinsulinemic Clamp Technique
Authors: F. JOHN SERVICE
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 March 1985Diagnosis of Insulinoma and the Euglycemic Hyperinsulinemic Clamp TechniqueF. JOHN SERVICE, M.D.F. JOHN SERVICE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-3-417 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo 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...References1. REYNOLDSKAMINSKYSCHADEEATON JNDR. Use of a computerized glucose clamp technique to diagnose an insulinoma. Ann Intern Med. 1984;101:648-9. LinkGoogle Scholar2. SERVICENELSONRUBENSTEINGO FRAV. Direct effect of insulin on secretion of insulin, glucagon, gastric inhibitory polypeptide and gastrin during maintenance of normoglycemia. J Clin Endocrinol Metab. 1978;47:488-93. CrossrefMedlineGoogle Scholar3. KRAEGENLAZARUSCAMPBELL ELL. Failure of insulin infusion during euglycemia to influence endogenous basal insulin secretion. Metabolism. 1983;32:622-6. CrossrefMedlineGoogle Scholar4. SERVICE F. Clinical presentation and laboratory evaluation of hypoglycemic disorders in adults. In: SERVICE FJ, ed. Hypoglycemic Disorders: Pathogenesis, Diagnosis and Treatment. Boston: G.K. Hall; 1983: 73-95. Google Scholar5. DAGGETTGOODBURNKURTZ PEA. Is preoperative localisation of insulinomas necessary? Lancet. 1981;1:483-6. CrossrefMedlineGoogle Scholar1. KRAEGENLAZARUSCAMPBELL ELL. Failure of insulin infusion during euglycemia to influence endogenous basal insulin secretion. Metabolism. 1983;32:622-7. CrossrefMedlineGoogle Scholar2. SERVICENELSONRUBENSTEINGO FRAV. Direct effect of insulin on secretion of insulin, glucagon, gastric inhibitory polypeptide, and gastrin during maintenance of normoglycemia. J Clin Endocrinol Metab. 1978;47:488-93. CrossrefMedlineGoogle Scholar3. ELAHINAGULESPARANHERSHCOPF DMR. Feedback inhibition of insulin secretion by insulin: relation to the hyperinsulinemia of obesity. N Engl J Med. 1982;306:1196-202. CrossrefMedlineGoogle Scholar4. LILJENQUISTHORWITZJENNINGSCHIASSONKELLERRUBENSTEIN JDAJUA. Inhibition of insulin secretion by exogenous insulin in normal man as demonstrated by C-peptide assay. Diabetes. 1977;27:563-70. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: F. JOHN SERVICE, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1985Volume 102, Issue 3Page: 417-418KeywordsComputersGlucoseHyperinsulinemiaHypoglycemiaInsulinoma ePublished: 1 December 2008 Issue Published: 1 March 1985 PDF downloadLoading ...