ECE2018 Nurse Sessions (1) (13 abstracts)
UK.
The Insulin Tolerance Test (ITT) is the gold standard test to assess growth hormone (GH) and ACTH reserve. This dynamic test induces hypoglycaemia and is commonly performed by endocrine nurses using different insulin doses -commonly 0.15 U or 0.10 U/kg. As part of a quality and safety improvement initiative we conducted a retrospective study to address several questions relating to ITT insulin dose. ITT results (n=148) were retrieved from two large endocrine testing centres. All tests that achieved adequate hypoglycaemia on 1st insulin dose and non-diabetic patients. All patients were given glucose after achieving hypoglycaemia at 30 mins.
Results:
Both insulin doses appear to achieve adequate hypoglycaemia
Patient glucose levels appear to recover more quickly with the lower dose thus an important patient safety aspect
Peak GH levels were similar between insulin doses
Patients receiving the standard (0.15 U/kg) dose were more likely to exhibit an adequate cortisol response, this might be due to the enhanced stimulus from longer hypoglycaemia although we cannot exclude that this is due to possible patient differences as this is not a truly random sample.