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      Cortisol Responses to the Insulin Hypoglycaemia Test in Children

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          Abstract

          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

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            Author and article information

            Journal
            HRE
            Horm Res Paediatr
            10.1159/issn.1663-2818
            Hormone Research in Paediatrics
            S. Karger AG
            1663-2818
            1663-2826
            2004
            March 2004
            02 March 2004
            : 61
            : 2
            : 92-97
            Affiliations
            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
            Article
            75339 Horm Res 2004;61:92–97
            10.1159/000075339
            14646394
            © 2004 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 1, Tables: 1, References: 18, Pages: 6
            Categories
            Original Paper

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