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DOI: 10.1055/s-2007-982516
© Georg Thieme Verlag KG Stuttgart · New York
Assessment of Suspected Insulinoma by 48-hour Fasting Test: A Retrospective Monocentric Study of 23 Cases
Publikationsverlauf
received 23.8.2006
accepted 11.12.2006
Publikationsdatum:
05. Juli 2007 (online)
![](https://www.thieme-connect.de/media/hmr/200707/lookinside/thumbnails/10.1055-s-2007-982516-1.jpg)
Abstract
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.
Key words
Insulinoma - glucose - insulin - neuroendocrine tumour - diagnosis - MEN - fasting test
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Correspondence
M. QuinklerMD
Clinical Endocrinology
Internal Medicine Centre for Gastroenterology, Hepatology, and Endocrinology
Charité Campus Mitte
Charitéplatz 1
10117 Berlin
Germany
Telefon: +49/30/45051 41 52
Fax: +49/30/45051 49 52
eMail: marcus.quinkler@charite.de