Related Experiment Video
Updated: Aug 8, 2026

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice
Published on: November 16, 2011
[Hypoglycemia insulin test in the assessment of the hypothalamic-pituitary-adrenal function]
Rocío Alfayate1, Montserrat Mauri, Marta de Torre
1Laboratorio de Hormonas, Hospital General Universitario de Alicante, Spain. alfayate_roc@gva.es
Background:
Recent advances in sensitivity and specificity of hormone immunoanalysis and their automatization have brought about changes in clinical laboratories that led us to review the need for some endocrine dynamic tests. The specific aim of this study was to determine the basal cortisol values predicting a normal or impaired response to the insulin hypoglycemia test (ITT).
Subjects And Method:
We retrospectively analysed cortisol responses to ITT in 320 subjects. Moreover, we studied the impact the use of a new strategy has on economic cost, by means of a relative value unit (RVU) calculation.
Results:
No patient with a basal cortisol < 6 g/dl (13%) responded to the test whereas all those with a basal cortisol > 18 g/dl responded in full. The rest of patients exhibited a basal cortisol level between 6-18 g/dl, 39% of them responding and 16% showing an inadequate response. Baseline and peak cortisol concentrations were strongly correlated (r = 0.74; p < 0.0001). The cost of ITT was 131.6 RVU as compared to 17.8 RVU for cortisol.
Conclusions:
Basal cortisol levels below 6 g/dl or above 18 g/dl make the test unnecessary. Cortisol measurement by automated methods, along with subsequent reduced assay times, allows us to apply new diagnosis strategies. Considering that the cost of ITT is 15 fold higher than that of single cortisol measurement, the potentially generated saving is significant.
More Related Videos
06:59Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
08:13Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test (OGTT) and Insulin Tolerance Test (ITT)
Published on: January 7, 2018
Related Concept Videos
Hormones Regulating Blood Glucose
In addition to accelerating glucose uptake and utilization, insulin has...
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
Insulin and C-peptide are co-secreted in...
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Hypoglycemia and Glucagon
Hypoglycemia
Hyperglycemia