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Evaluation of the pituitary function with insulin tolerance (hypoglycaemia) testing: are there any differences using
Kevin C J Yuen1, Rakesh Amin, Marie B Cook
1Department of Endocrinology, Oregon Health and Science University, Portland, Oreg. 97239-3098 USA. yuenk@ohsu.edu
Background/Aim:
The insulin tolerance test (ITT) remains the gold standard for evaluating the pituitary function, but has potential risks when hypoglycaemia is induced. There are scarce data using short-acting insulin analogs for ITTs. This pilot study compares the effects of insulin lispro (LPI) with regular insulin (RGI) during an ITT.
Methods:
Patients with suspected hypopituitarism (n = 103) randomly received either LPI (n = 51) or RGI (n = 52).
Results:
All patients reported signs and symptoms when hypoglycaemia was induced. In the LPI group, hypoglycaemia occurred sooner (23.6 +/- 1.6 vs. 28.3 +/- 1.4 min, p < 0.05), and duration of hypoglycaemia (25.0 +/- 1.7 vs. 31.9 +/- 1.9 min, p < 0.05) and time for blood glucose levels to return to a 'safe' level (>3.3 mmol/l; 56.5 +/- 2.3 vs. 76.0 +/- 2.1 min, p < 0.001) were shorter as compared with the RGI group. No differences in peak growth hormone and cortisol levels were observed between the two groups.
Conclusions:
Our data suggest that despite inducing similar symptomatology, LPI exerted a quicker onset and a shorter duration of hypoglycaemia as compared with RGI. Thus, using LPI might reduce the potential risks associated with an ITT by shortening the hypoglycaemic phase of the test.
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