Background: Organic hyperinsulinism is treated as a rule conservatively with diazoxide (Proglicem) which has a hyperglycaemic effect. In some patients, however, treatment fails and severe hypoglycaemia persists. The objective of the present investigation was to find simple criteria for evaluation of the aptness (effectiveness) of this treatment.
Methods and results: In 11 patients with a confirmed insulinoma Proglicem was administered for five days (3 mg/kg body weight) and serum insulin and the blood sugar level as well as their ratio (IRI:G) were followed-up. In eight patients the IRI/G coefficient declined from 10.5 +/- 7.7 to 5.8 +/- 2.9 (p < 0.001); only in three patients the coefficient increased from 4.6 +/- 2.9 to 14.9 +/- 12.3 (p < 0.001). Coefficient "k" from the modified Bergman model for the intravenous glucose tolerance test had identical results; there was statistically significant agreement between the two examinations.
Conclusions: To assess the effectiveness of diazoxide treatment (Proglicem) on hypoglycaemia in nesidiomas it is sufficient to evaluate the IRI/G coefficient (on fasting) before and during diazoxide treatment (Proglicem, Schering Corp.).