There is still doubt concerning the presence of pituitary or adrenal insufficiency in patients with rheumatoid arthritis. The glucose-insulin tolerance test has previously been studied by several authors and is considered a good index of pituitary and adrenal function. The test is based on the observation that, in normal individuals, the administration of glucose (30 to 60 minutes after insulin-induced hypoglycemia) is followed by hyperglycemia of greater intensity than that obtained by giving glucose without previously giving insulin. Thus, administration of glucose accentuates the homeostatic reaction to hypoglycemia, believed to be mediated by hormones of the anterior pituitary and from the adrenal cortex and medulla.
Patients with adrenal or pituitary insufficiency and with hyperinsulinism show an exaggerated reaction to insulin, and spontaneous rise in the blood sugar level after induced hypoglycemia is retarded. One of the advantages of the glucose-insulin test is that, with the administration of glucose, the danger
Houli J, Filho HP. GLUCOSE-INSULIN TOLERANCE TEST IN RHEUMATOID ARTHRITISSTUDY OF TWENTY-NINE CASES. JAMA. 1955;159(6):561–562. doi:10.1001/jama.1955.02960230025009a