Related Experiment Video
Updated: Apr 27, 2026

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
A comparison of low-dose ACTH, glucagon stimulation and insulin tolerance test in patients with pituitary disorders
Y Simsek1, Z Karaca, F Tanriverdi
1Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
Context:
Diagnosis of secondary adrenal insufficiency and GH deficiency requires evaluation by dynamic stimulation tests in most cases. Although insulin tolerance test (ITT) is accepted as the gold-standard test for the evaluation of both hypothalamo-pituitary-adrenal (HPA) and (GH)-IGF-1 axes, the test is cumbersome. In clinical practice, low-dose adrenocorticotrophic hormone (ACTH) stimulation test is a sensitive, safe and easily applicable alternative to ITT. Although it takes more time, glucagon stimulation test (GST) is also a good alternative to ITT and can evaluate both axes.
Objective:
The primary aim of this study was to compare the ITT, low-dose ACTH and GSTs in the evaluation of HPA and GH-IGF-1 axes in patients with pituitary disorders and to evaluate the repeatability of all three tests.
Design:
ITT, low-dose ACTH and GSTs were performed in all 129 patients, and the tests were repeated in 66 of these patients.
Setting:
Erciyes University Medical School, Department of Endocrinology.
Patients Or Other Participants:
One hundred and twenty-nine adult patients (76 women, 53 men) with pituitary disorder were included in the study.
Main Outcome Measure(S):
The cortisol and GH responses of patients to dynamic tests.
Results:
Peak cortisol levels obtained during ITT were significantly lower than the values obtained during both low-dose ACTH and GSTs. Peak cortisol levels obtained during the GST were lower than those found during the low dose ACTH stimulation test. Peak GH responses were found to be higher in GST than in ITT. All three tests had good reproducibility.
Conclusions:
Any of 3 tests can be used in the evaluation of the HPA axis and either GST or the ITT can be used in the evaluation of the GH-IGF-1 axis but cut-off levels for the insufficiency of HPA or GH-IGF-1 axis should be individualized for each test.
More Related Videos
07:30Homogeneous Time-resolved Förster Resonance Energy Transfer-based Assay for Detection of Insulin Secretion
Published on: May 10, 2018
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
Hypoglycemia and Glucagon
Cushing Syndrome II: Pathophysiology
Cushing Syndrome I: Introduction
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...
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
Insulin and C-peptide are...