An<unk>  <unk>  is a medical diagnostic procedure during which insulin is injected into a patient's vein, after which blood glucose is measured at regular intervals. This procedure is performed to assess pituitary function, adrenal function, insulin sensitivity, and sometimes for other purposes. An<unk>  is usually ordered and interpreted by endocrinologists. When used to assess insulin sensitivity, a standard dose of insulin is administered, and blood glucose is monitored with frequent sampling; the plasma glucose disappearance rate (KITT) indicates the degree of whole-body insulin sensitivity, and correlates well with the gold-standard glucose clamp technique. When used for assessing the integrity of the hypothalamic–pituitary–adrenal axis (HPA), insulin injections are continued to the point of inducing extreme hypoglycemia below 2.2 mmol/l (40 mg/dl). Patient must have symptomatic neuroglycopenia to trigger counter-regulatory cascade. Glucose levels below 2.2 mmol/L are insufficient absent symptoms. The brain must register low glucose levels. In response, adrenocorticotropic hormone (ACTH) and growth hormone (GH) are released as a part of the stress mechanism. ACTH elevation causes the adrenal cortex to release cortisol. Normally, both cortisol and GH serve as counterregulatory hormones, opposing the action of insulin, i.e. acting against the hypoglycemia.<unk>  to the point of extreme hypoglycemia is considered to be the gold standard for assessing the integrity of the HPA. Sometimes<unk>  is performed to assess the peak adrenal capacity, e.g. before surgery. It is assumed that the ability to respond to insulin induced hypoglycemia translates into appropriate cortisol rise in the stressful event of acute illness or major surgery.The extreme hypoglycemic version of the<unk>  is potentially very dangerous and must be undertaken with great care, because it can iatrogenically induce the equivalent of a diabetic coma. A health professional must attend it at all times. Other provocation tests which cause much less release of growth hormone include the use of glucagon, arginine and clonidine.
Insulin tolerance test
Glucose tolerance test
Postprandial glucose test
Quantitative insulin sensitivity check index
Glucose test
Random glucose test
Insulin index
Ambulatory glucose profile