The insulin tolerance test is used to evaluate patients with suspected adrenal or pituitary gland problems. The patient receives an injection of insulin to lower blood sugar, causing cortisol and growth hormone levels to rise. Patients may feel tired and shaky after the test, and constant monitoring is needed to prevent complications. The test can be definitive for a concerned endocrinologist, despite the risks.
An insulin tolerance test (ITT) is a medical test that an endocrinologist may recommend to evaluate a patient with a suspected adrenal or pituitary gland problem. In this test, the patient receives an injection of insulin to lower blood sugar, forcing the body into hypoglycemia. This should cause a stress reaction in which cortisol and growth hormone levels rise. Otherwise, the patient’s endocrine system may malfunction. You may need to supplement with growth hormone or run some tests to find out more about what’s going on.
Before the test, patients may not be allowed to eat for several hours. They also need to temporarily stop taking steroid medications, as it could nullify the test results. It can take several hours to complete an insulin tolerance test, and it’s a good idea to go home afterward. Patients often feel tired and shaky after the test and may not be able to drive or go back to work for the rest of the day.
The test begins with the collection of a reference blood sample. A doctor injects insulin and stays in the room at all times to monitor the patient, taking periodic samples to check blood sugar levels. Samples may also be taken to check the concentration of hormones in the blood, which should start to rise as the patient becomes hypoglycemic. When the test is over, the doctor may give the patient juice or a snack to raise blood sugar levels.
Patients may not feel very well during an insulin tolerance test. Hypoglycemia can make people feel shaky, sweaty, tired, and irritable. Those who lose consciousness may need a bolus of medication to rapidly elevate blood sugar levels. Constant monitoring is needed to make sure early warning signs of complications are identified early and that medications can be kept on hand to reverse the effects of insulin if needed. Fatigue and dizziness are not uncommon even after blood sugar has returned, because the patient’s body may still be adjusting.
If the adrenal gland is malfunctioning, cortisol levels won’t rise during an insulin tolerance test. Growth hormone levels may also be low, indicating that there is a problem with the pituitary gland. Insulin tolerance testing can be definitive for a concerned endocrinologist for a patient, which is why it may be recommended despite the risks. As long as a patient is properly monitored, the chances of serious complications are low.
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