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

P. Cohen, Nir Barzilai, R. Bar-Ilan, K. Yassin, E. Karnieli

Research output: Contribution to journalArticle

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Abstract

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·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 < 0.01) and 48% (P < 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.

Original languageEnglish (US)
Pages (from-to)1411-1413
Number of pages3
JournalJournal of Clinical Endocrinology and Metabolism
Volume63
Issue number6
StatePublished - 1986
Externally publishedYes

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Insulinoma
Hyperinsulinism
Insulin
C-Peptide
Glucose Clamp Technique
Plasmas
Clamping devices

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Lack of suppression of insulin secretion by hyperinsulinemia in a patient with an insulinoma. / Cohen, P.; Barzilai, Nir; Bar-Ilan, R.; Yassin, K.; Karnieli, E.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 63, No. 6, 1986, p. 1411-1413.

Research output: Contribution to journalArticle

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