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Exp Clin Endocrinol Diabetes. 2014 Mar;122(3):149-53. doi: 10.1055/s-0033-1363260. Epub 2014 Mar 18.

Mini-fasting tests diagnosing endogenous hyperinsulinism: a follow-up of 26 cases.

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  • Endocrinology Division, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Rua dos Mundurucus, Guamá, Belém, Pará, Brazil.

Abstract

CONTEXT:

The supervised 72-h fast remains the gold standard test for the diagnosis of endogenous hyperinsulinism and has recently been suggested to be shortened or even avoided.

OBJECTIVE:

This study aimed to evaluate whether measurement of blood glucose, insulin and C-peptide levels after a 12 h overnight fast (mini-fasting test), in at least 3 consecutive days, could allow making or ruling out diagnosis of endogenous hyperinsulinism, according to the Endocrine Society's recent guidelines.

PATIENTS AND METHODS:

We performed 12 h mini-fasting test in at least 3 consecutive days, dosing blood glucose, insulin and C-peptide levels in 26 inpatient patients with pathologically proven endogenous hyperinsulinism.

RESULTS:

In our series, 100% of patients showed insulin levels of at least 3 μU/ml and C-peptide levels of at least 0.6 ng/ml concomitant with symptomatic hypoglycemia (≤ 55 mg/dl).

CONCLUSION:

It leads to the conclusion that mini-fasting test might avoid, in most cases, prolonged fasting test for the diagnosis of hypoglycemia due to endogenous hyperinsulinism.

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

PMID:
24643691
[PubMed - in process]
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