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Journal of Clinical Endocrinology & Metabolism, Vol 63, 1411-1413, Copyright © 1986 by Endocrine Society

ARTICLES

Lack of suppression of insulin secretion by hyperinsulinemia in a patient with an insulinoma

P Cohen, N Barzilai, R Bar-Ilan, K Yassin and E Karnieli

The regulation of insulin secretion in patients with insulinoma is known to be abnormal. For example, physiological and pharmacological stimuli often fail to stimulate insulin in such patients. Recently, insulin has been found to inhibit its own secretion in normal subjects. To determine if insulin has this effect in patients with insulinoma, we infused insulin at rates of 1 and 10 mU/kg X min in such a patient and in eight normal subjects. Euglycemia was maintained by the euglycemic glucose clamp technique, and endogenous insulin secretion was estimated by measuring plasma C-peptide levels. In the normal subjects, plasma C- peptide declined from 1.60 +/- 0.22 (+/- SEM) to 1.16 +/- 0.17 and 0.82 +/- 0.11 ng/ml during the low and high dose insulin infusions, respectively, indicating 27% (P less than 0.01) and 48% (P less than 0.001) decreases in endogenous insulin secretion at moderately elevated and extremely elevated insulin levels, respectively. In the insulinoma patient, plasma C-peptide was 2.6 ng/ml basally, did not change during the low dose insulin infusion, and rose to 3.4 ng/ml during the high dose insulin infusion. We conclude that the feedback regulation of insulin secretion by insulin that occurs in normal subjects is absent in insulinoma patients. This finding could have pathophysiological and possibly diagnostic significance.


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L. E. Levitt Katz, R. J. Ferry Jr., C. A. Stanley, P. F. Collett-Solberg, L. Baker, and P. Cohen
Suppression of Insulin Oversecretion by Subcutaneous Recombinant Human Insulin-Like Growth Factor I in Children with Congenital Hyperinsulinism Due to Defective {beta}-Cell Sulfonylurea Receptor
J. Clin. Endocrinol. Metab., September 1, 1999; 84(9): 3117 - 3124.
[Abstract] [Full Text]


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