Diazoxide Infusion Test in Patients with Single Benign Insulinoma

Abstract

The diazoxide infusion test (600 mg i.v. over a 1-hour period) was performed in 12 patients bearing single benign islet B-cell adenoma and in 6 normal subjects. Blood glucose, plasma insulin and glucagon concentrations were measured every 15 min during the infusion and thereafter up to 150 min. In insulinoma patients, blood glucose levels failed to increase significantly while in the control group a significant rise starting from 30 min persisted throughout the test (p < 0.05 or less). Plasma insulin mean levels decreased significantly in normal subjects from 30 to 60 min (p < 0.05), while they were significantly suppressed in hypoglycemic patients from 15 to 120 min (p < 0.02). Diazoxide administration induced in the normal group a significant decrease in glucagon levels (p < 0.02 from 30 to 150 min) whereas no such suppression occurred in patients. In our experience, insulin response to diazoxide infusion in patients with insulinoma may provide additional information for diagnosis.

The ultrasonic detection of insulinomas during surgical exploration of the pancreas

“…On the basis of the data available in international reports and our own experience with 54 patients with organic hypoglycemia we can state that this diagnosis can be made by: (a) neuroglycopenic symptoms during fasting, (b) hypoglycemia (< 40 rag/100 ml = 2.2 mmol/I), (c) relief of symptoms after glucose administration, and (d) determination of the glycemia/insutinemia ratio [4,11,32,331. Besides the prolonged fasting test, indications of diagnostic value can be obtained in cases of endogenous hyperinsulinism using the somatostatin and diazoxide suppression test [5,34,35].…”

Dietary and pharmacological modification of the insulin/IGF-1 system: exploiting the full repertoire against cancer

“…192 In moderately overweight patients with polycystic ovary syndrome, 300 mg diazoxide per day also reduced IGF-1 from 314.5 to 219.5 ng/ml ( P <0.01). 193 Furthermore, diazoxide inhibits glucagon secretion in healthy man 194 and in the dog, 195 but stimulates glucagon release in rats. 196 …”