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C-peptide suppression test for insulinoma.

F J Service, D L Horwitz, A H Rubenstein

The Journal of Laboratory and Clinical Medicine

|July 1, 1977

Summary

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This study shows that C-peptide levels during induced hypoglycemia can help diagnose insulinoma. Most insulinoma patients failed to suppress C-peptide, unlike healthy individuals, suggesting a diagnostic test for insulinoma.

Area of Science:

Endocrinology
Medical Diagnostics

Background:

Insulinoma is a rare tumor causing hypoglycemia due to excessive insulin production.
Accurate diagnosis of insulinoma is crucial for effective management.

Purpose of the Study:

To evaluate the utility of C-peptide suppression during insulin-induced hypoglycemia as a diagnostic marker for insulinoma.

Main Methods:

Insulinoma patients and normal subjects underwent induced hypoglycemia via porcine insulin infusion.
Plasma glucose and C-peptide immunoreactivity (CPR) levels were measured.
CPR suppression patterns during hypoglycemia were analyzed.

Main Results:

Normal subjects showed suppressed CPR (<= 1.2 ng/ml) during hypoglycemia (plasma glucose <= 40 mg/dl).

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Eleven of twelve insulinoma patients exhibited impaired CPR suppression (>= 1.9 ng/ml).

One patient had borderline results, suggesting potential impaired suppression at lower glucose levels (<= 30 mg/dl).

Conclusions:

Impaired C-peptide suppression during insulin-induced hypoglycemia is a sensitive indicator for insulinoma.
This test offers a valuable diagnostic tool for identifying insulinoma.