Wolfe WG, Mullen DC, Silver D. Insulinoma of the PancreasUse of the Tolbutamide Test, Arteriography, and Selenium Scan in Modern Diagnosis. Arch Surg. 1972;104(1):56-59. doi:10.1001/archsurg.1972.04180010050013
Hyperinsulinism, secondary to islet cell tumors of the pancreas, is a relatively uncommon but serious disorder. In the past, it has been difficult to diagnose, identify, and remove the tumor. Insulin-secreting tumors of the pancreas occurred in 12 of our patients. Current endocrinologic and radiological methods allow the establishment of a diagnosis and localization of islet cell tumors with assurance. Patients with symptoms suggesting hyperinsulinism should undergo fasting blood glucose and tolbutamide tolerance tests. If these studies suggest the presence of a hypersecreting tumor of the pancreas, a celiac arteriogram may accurately localize the tumor (or tumors) so that "blind" resection of the pancreas will be unnecessary.