Optimizing the method in calculating the insulin dosages in the insulin hypoglycemia-growth hormone stimulation test: preliminary exploration

Objective To explore more suitable calculation method of the insulin dosage in insulin hypoglycemia-growth hormone stimulation test(insulin tolerance test, ITT). Methods Fifty-six subjects suspected of growth hormone deficiency were divided into primary and secondary onset groups. All the patients took oral glucose tolerance test and ITT. Homeostasis model of assessment for insulin resistance index(HOMA-IR)and insulin sensitivity index(ISI), area under insulin curve(AUCINS)and the area under glucose curve(AUCPG)were calculated. The insulin dosages during ITT between two groups were compared and the main factors influencing the insulin dosage were analyzed. Results There was no difference in the insulin dosage during ITT between primary and secondary groups. The actual dosage of insulin in this cohort study revealed a significant difference from the initial insulin dosage recommended by the guideline. Multiple linear regression analysis found that AUCINS and body mass index were the independent factors affecting the insulin dosage. Then the optimized coefficient of ITT(γ)were found. Conclusion The insulin dosage used in our study was inconsistent with the guidelines-recommended ones. In order to make ITT more efficient and safer, a more optimized calculation method to improve the successful rate of insulin-induced hypoglycemia in ITT is proposed. (Chin J Endocrinol Metab, 2017, 33: 29-33) Key words: Insulin hypoglycemia-growth hormone stimulation test; Oral glucose tolerance test and insulin release test; Area under curve of insulin; Optimized coefficient