Due to potentially difficult logistics and and the expected as well as necessary development of hypoglycemia in patients suspicious to suffer an insulinoma fasting tests should be carried out in institutions able to deal with hypoglycemias. !
Without adaequate logistics in regard to
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1. possibility to draw blood samples (24 h / day) |
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2. immediate adaequate photometric blood glucose analysis |
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3. centrifugation and storage of aliquots timely coordinated with blood glucose measurements |
fasting test should be the business of professionals !
A prerequisite for the adaequate performance of a fasting test is the availability of an immediate (bed-side) and exact photometrical determination of the
blood glucose concentration by means of a true glucose analyzer , e.g. 
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Blood glucose estimations by means of test strip technology, as used by diabetic patients, should be strictly avoided ! |
There should be a clear understanding of the used
insulin assay technology .
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Unknown cross-reactivity of the insulin assay with proinsulin is unacceptable and might result in a missed diagnosis ! |
The fasting test is a potentially invasive endocrinological suppression test !
Fasting tests performed on an outpatient ambulatory basis without continuous medical care (including overnight) are discouraged.