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'''Whipple's triad''' or '''Whipple's criteria''' is a medical term which refers to three conditions that are considered by physicians necessary for proving [[hypoglycemia]] as the cause of a person's [[symptom]]s. They are stated in various versions, but the essential conditions are:
#Symptoms known or likely to be caused by hypoglycemia
#A low glucose measured at the time of the symptoms
#Relief of symptoms when the glucose is raised to normal

==History==
The criteria date back to the 1930s, when it had been discovered that a few patients with hypoglycemic symptoms (such as shakiness, [[syncope]] or [[diaphoresis|sweating]]) due to hypoglycemia could be cured by [[surgery]] to remove an [[insulinoma]]. However, it had also become apparent that a large proportion of people with symptoms suggestive of hypoglycemia had no need of surgery. Diagnostic testing was rudimentary: beyond a crude assay for [[reducing substance]]s as an indirect measure of blood [[glucose]], there was no way to measure [[hormone]]s and metabolites such as [[insulin]], and no [[radiology|imaging procedures]] for internal [[organ (anatomy)|organ]]s such as the [[pancreas]]. 

[[Allen Whipple|Allen O. Whipple]] was a well-known surgeon who had pioneered pancreatic surgery.  In an article entitled "The surgical therapy of hyperinsulinism", in ''J Internat Chir'' 3:237-276 (1938), he proposed that no pancreatic surgery to look for an insulinoma be performed unless these criteria were met.

==Current use of the triad==
The use and significance of the criteria have evolved over the last century as our understanding of the many forms of hypoglycemia has increased and our [[medical test|diagnostic test]]s and imaging procedures have improved. Whipple's criteria are no longer used to justify surgical exploration for an insulinoma, but to separate "true hypoglycemia" in which a low glucose can be demonstrated from a variety of other conditions (e.g., [[idiopathic postprandial syndrome]]) in which symptoms suggestive of hypoglycemia occur but low glucose levels cannot be demonstrated. The criteria are now invoked far more often by [[endocrinologist]]s than by surgeons. The reliability of the criteria for this purpose has been a subject of contention among physicians.

==In Popular Culture==
Elliot in the tv series [[Scrubs(series)|Scrubs]] was unable to name Whipple's Triad in the episode "[[My Balancing Act]]".

==See also==
* [[Hypoglycemia]]
* [[Causes of hypoglycemia]]

[[Category:Endocrinology]]
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