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      Cortisol Responses to the Insulin Hypoglycaemia Test in Children

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          Aim: To determine the timing of the peak cortisol response to the insulin hypoglycaemia (IH) test in children and to establish paediatric reference data. Methods: We retrospectively reviewed all IH tests in a tertiary paediatric endocrine referral centre over a 6-year period. Inclusion criteria were age <16 years and adequate hypoglycaemia (glucose ≤2.0 mmol/l). Patients with an impaired hypothalamic-pituitary-adrenal axis or receiving glucocorticoid medication were excluded. Fifty-four subjects (35 males) met the criteria. Blood samples were collected at –30, 0, 20, 30, 60, 90, 120, and 150 min in relation to insulin bolus injection (0.15 U/kg) at 0 min. Glucose, cortisol, and growth hormone (GH) were measured in all samples. Results: Peak cortisol and GH responses occurred by 90 min in all subjects. Peak cortisol was inversely correlated with age (r<sub>s</sub> –0.65, p < 0.0001). The median (5th centile) peak cortisol value was 689 nmol/l (547 nmol/l) in children younger than 10 years as compared with 555 nmol/l (468 nmol/l) in those older than 10 years (p < 0.0001). Peak cortisol was not related to peak GH (r<sub>s</sub> –0.20, p = 0.15). Conclusions: Blood sampling in the IH test may be curtailed 90 min after injection. The peak cortisol response to IH is age related.

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          Safety of the insulin tolerance test


            Author and article information

            Horm Res Paediatr
            Hormone Research in Paediatrics
            S. Karger AG
            March 2004
            02 March 2004
            : 61
            : 2
            : 92-97
            aDepartment of Paediatric Biochemistry, Royal Hospital for Sick Children, Edinburgh, bSection of Child Life and Health, Department of Reproductive and Developmental Sciences, University of Edinburgh, and cDepartment of Clinical Biochemistry, Royal Infirmary, Edinburgh, UK
            75339 Horm Res 2004;61:92–97
            © 2004 S. Karger AG, Basel

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            Figures: 1, Tables: 1, References: 18, Pages: 6
            Original Paper


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