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  • Title: Mini-fasting tests diagnosing endogenous hyperinsulinism: a follow-up of 26 cases.
    Author: Felício JS, Koury CC, Martins CL, Miléo KB, Neto JF, de Melo FT, de Souza AC.
    Journal: Exp Clin Endocrinol Diabetes; 2014 Mar; 122(3):149-53. PubMed ID: 24643691.
    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.
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