Carcinoma of the Islets of Langerhans

Cleempoel, H; Conard, V.; Bastenie, Paul Auguste

doi:10.1016/s0140-6736(55)92390-4

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…In the main, diagnostically useful 'excessive' insulin responses were obtained with tolbutamide (five out of nine subjects tested), glucagon (seven out of 14 subjects tested), and occasionally, 1-leucine. In contrast the insulin response to intravenous glucose was usually normal (four out of six subjects tested) or subnormal (one out of six subjects) and explains our failure previously (Marks and Marrack, 1962) to find the anticipated (Cleempoel, Conard, and Bastenie, 1955) increase in peripheral glucose assimilation after intravenous glucose had been given to patients with insulinoma.…”

Section: Plasma Insulin Response During Other Pro-vocative Tests In Imentioning

confidence: 56%

Glucagon test for insulinoma: a chemical study in 25 cases

Marks¹,

Samols²

1968

J Clin Pathol

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SYNOPSISThe capillary blood glucose response to lmg of intramuscular glucagon was determined in 13 patients with insulinoma and in 33 normal controls; the insulinoma patients showed a normal initial rise, but this was followed by an abnormally large fall, reaching hypoglycaemic levels between 90 and 180 minutes in every case. In 14 insulinoma patients the response of venous blood glucose and also plasma insulin to lmg of intravenous glucagon was compared with 10 normal controls; there was an abnormally large rise of plasma insulin in 10 of the 14 patients, and in the majority the venous blood glucose was below normal throughout the test. In these 14 patients the plasma insulin response was also determined after oral and intravenous glucose, after oral leucine, and after intravenous tolbutamide, and the value of these tests in the recognition and differential diagnosis of insulinoma was compared with that of the intravenous glucagon test. MATERIALS AND METHODSTwenty-five patients with hyperinsulinism were studied, two of them (A.B. and W.K.) on more than one occasion. In 24 patients an insulinoma was found at operation; 18 were benign and five were malignant with metastases. The remaining patient (W.K.), who at first refused operation, was operated upon four years later but no tumour found though clinically the diagnosis was not in doubt; both fasting hypoglycaemia and hyperinsulinaemia persisted postoperatively. In addition two patients with hypoglycaemia due to extrapancreatic neoplasms, four with hepatogenous hypoglycaemia, three with essential reactive hypoglycaemia, and one with hypoglycaemia due to hypopituitarism were also studied.Control subjects were healthy laboratory personnel, or non-obese, non-diabetic hospital inpatients free from endocrine, hepatic, or metabolic disease. In addition five healthy, obese, non-diabetic subjects were investigated.Glucagon tests were carried out on patients and controls maintained on a high carbohydrate diet by one of the following procedures.

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Section: Plasma Insulin Response During Other Pro-vocative Tests In Imentioning

confidence: 56%

Glucagon test for insulinoma: a chemical study in 25 cases

Marks¹,

Samols²

1968

J Clin Pathol

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“…Comparable values of k in male subjects (30) are in close agreement with those of the nonpregnant female group, being 1.68 ± 0.9 and 1.67 + 0.08, respectively. Cleempoel, Conard and Bastenie (41) reported normal values at 1.80 + 0.16.…”

Section: Resultsmentioning

confidence: 93%

The Rapid Intravenous Glucose Tolerance Test in Pregnancy*

Silverstone¹,

Solomons²,

Rubricius³

1961

J. Clin. Invest.

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“…The diminished glucose tolerance in the older individual might be due to: (a) inadequate release of insulin from the pancreas, or greater inactivation of endogenously released insulin, (b) the loss of functioning protoplasm with increasing age so that less metabolizing tissue is removing glucose from the blood, (c) a diminution in the effectiveness of the metabolic processes involved in the removal of sugar from the blood stream, (d) alterations in the rate of release of glucose from the liver, or (e) a reduction in the volume in which the glucose is originally distributed in the aged. By comparing the glucose and glucose-insulin tolerance tests in the same individual, an estimate of the effect of insulin may be obtained (21)(22)(23)(24)(25)(26)(27). In the experiments to be reported, standard amounts of insulin were administered along with glucose to both old and young subjects with the aim of investigating age differences in the response to the insulin.…”

mentioning

confidence: 99%

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Silverstone¹,

Brandfonbrener²,

Shock³

et al. 1957

J. Clin. Invest.

130

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In addition to providing information with regard to the status of carbohydrate metabolism, the time course of the disappearance of injected glucose from the blood stream offers information concerning the overall effectiveness of a variety of physiological mechanisms involved in maintaining homeostasis. In a number of investigations, reduction in glucose tolerance, i.e., a slower rate of return to fasting levels of blood sugar following the oral (1-17) or intravenous (18)(19)(20) administration of glucose, has been reported in older people. The diminished glucose tolerance in the older individual might be due to: (a) inadequate release of insulin from the pancreas, or greater inactivation of endogenously released insulin, (b) the loss of functioning protoplasm with increasing age so that less metabolizing tissue is removing glucose from the blood, (c) a diminution in the effectiveness of the metabolic processes involved in the removal of sugar from the blood stream, (d) alterations in the rate of release of glucose from the liver, or (e) a reduction in the volume in which the glucose is originally distributed in the aged. By comparing the glucose and glucose-insulin tolerance tests in the same individual, an estimate of the effect of insulin may be obtained (21)(22)(23)(24)(25)(26)(27). In the experiments to be reported, standard amounts of insulin were administered along with glucose to both old and young subjects with the aim of investigating age differences in the response to the insulin. Table I. Experimental procedure. The intravenous glucose tolerance test (GTT) and the glucose-insulin tolerance test (GITT) were performed in each subject under basal conditions and separated by an interval of not less than one week. In 8 of the subjects, each of the tests (GTT and GITT) was carried out twice in order to evaluate reliability.Twenty minutes before either test was begun, a modified Lindeman needle was placed in an antecubital vein and left in place for the duration of the test. The needle was kept patent by heparinization of the stylus and was used subsequently only for withdrawing blood specimens without a tourniquet (29). A vein in the opposite arm was used for the injection of 50 ml. of 50 per cent glucose in water over a period of two minutes. For the GITT, 5 units of hyperglycemic factor-free insulin8 (Lilly), per square meter of body surface area, were rapidly injected, followed immediately by the standard amount of glucose. The fasting blood specimen was obtained through the Lindeman needle a few minutes before zero time, which was recorded as the beginning of the injection of glucose.Blood samples were collected at 5-minute intervals for the first hour and at 20-minute intervals during the second hour, and were placed immediately in tubes containing a dried heparin and sodium fluoride mixture. All analyses were completed the day of the test, using the Nelson-Somogyi method (30). Determinations were in duplicate and were read on a Model DU Beckman Spectrophotometer.Data analysis. For each tolerance test...

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Carcinoma of the Islets of Langerhans

Cited by 11 publications

References 8 publications

Glucagon test for insulinoma: a chemical study in 25 cases

Glucagon test for insulinoma: a chemical study in 25 cases

The Rapid Intravenous Glucose Tolerance Test in Pregnancy*

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

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