Insulinoma laboratory tests: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of insulinoma include 72h suppression test and Whipple's triad. | Laboratory findings consistent with the diagnosis of insulinoma include 72h suppression test and Whipple's triad.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217 }} </ref> | ||
==Laboratory Tests== | ==Laboratory Tests== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of insulinoma include 72h suppression test and Whipple's triad.[1]
Laboratory Tests
Laboratory findings consistent with the diagnosis of insulinoma include:[1]
Whipple's Traid
The diagnosis of insulinoma is suspected in a patient with symptomatic fasting hypoglycemia. The conditions of Whipple’s triad need to be met for the diagnosis of insulinoma are:[1]
- 1. Hypoglycemia(plasma glucose < 50 mg/dL)
- 2. Neuroglycopenic symptoms
- 3. Reversibility of symptoms with administration of glucose
Suppression Tests
The gold standard blood tests needed to diagnose insulinoma during a 72 hour fast are:[1]
The sensitivity of combination of these 4 tests after 72h fasting is around 99%.
Normally, endogenous insulin production is suppressed in the setting of hypoglycemia. A 72-hour fast, usually supervised in a hospital setting, can be done to see if insulin levels fail to suppress, which is a strong indicator of the presence of an insulin-secreting tumor. During the test, the patient may have calorie-free and caffeine-free liquids. Capillary blood glucose is measured every 4 hours using a reflectance meter, until values < 60 mg/dL (3.3 mmol/L) are obtained. Then, the frequency of blood glucose measurement is increased to every hour until values are < 49 mg/dL (2.7 mmol/L). At that point, or when the patient has symptoms of hypoglycemia, a blood test is drawn for serum glucose, insulin, proinsulin, and C-peptide levels. The fast is stopped at that point, and the hypoglycemia treated with intravenous dextrose or calorie-containing food or drink.[2]
References
- ↑ 1.0 1.1 1.2 1.3 Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y; et al. (2013). "Diagnosis and management of insulinoma". World J Gastroenterol. 19 (6): 829–37. doi:10.3748/wjg.v19.i6.829. PMC 3574879. PMID 23430217.
- ↑ Insulinoma. Wikipedia. https://en.wikipedia.org/wiki/Insulinoma