Tolbutamide Tolerance in Hypoglycemic Children

Endogeneous Insulin and Growth Hormone Response in Children with Newly Diagnosed Diabetes Mellitus

“…There was, however, an appreciable and prompt increase in the concentration of insulin and a modest, slower increase in the concentration of growth hormone. These results are similar to the observations reported for normal subjects, but the magnitude of the changes in concentration of growth hormone are somewhat less than those which others have reported [4,6,16,34,36,37,40,41,43]. In the diabetic, infusion of arginine and of tolbutamide is associated with a continuous, gradual decline in the concentration of glucose.…”

“…This was followed by a reactive increase in the concentration of growth hormone which reached a peak at 60 minutes. These responses are not appreciably different from those reported by other investigators for normal children and adults [4,6,16,34,36,37,40,41,43]. In the diabetics, there was a slow, continuous decline in the concentration of glucose in blood over the two-hour period of observation.…”

Insulinoma in childhood.

“…The failure to show this in our patient before operation was disappointing, but others (Cunningham, 1964;Drash and Schultz, 1967;Garces et al, 1968;Marks and Rose, 1965) have had similar negative results. It is possible that we missed the peak plasma insulin level as this may occur within 5 minutes of the tolbutamide injection (Maingay et al, 1967).…”

“…However, many investigators (Antony et al, 1967;Cunningham, 1964;Di George and Chiowanich, 1962;Drash and Schultz, 1967;Erlich and Martin, 1967;Schotland, Kaplan, and Grumbach, 1967) have found the test less valuable in childhood. This is because similar results occur in children with hypoglycaemia from other causes, notably McQuarrie's idiopathic type, leucine-sensitivity, and islet cell hyperplasia.…”