Insulin Glucose Ratio

The insulin-glucose (I/G) ratio provides a relationship between these two values that aids in the determination of the presence of an insulinoma. In a normal individual, the ratio is always less 0.4, but in patients with an insulinoma the ratio approaches 1.0 and may in some cases exceed 1.0. The I/G ratio is important because as many as one third of patients with an insulinoma have insulin levels within normal limits when they have symptomatic hypoglycemia.

I 40

g 30

20 10 0

OP <001

50 f

Normals n = 33

Adenomas n = 22

FIGURE 79-3. Plasma insulin (in microunits per milliliter) and blood glucose (milligrams per deciliter). Relationships after overnight fasting in 33 normal persons and in 22 patients with solitary beta islet cell adenomas. Both plasma insulin and blood glucose show highly significant differences between the two groups. IRI = immunoreactive insulin. (From Harrison TS. Hyperinsulinism and its surgical management. In: Hardy JD [ed], Rhoads' Textbook of Surgery: Principles and Practice. Philadelphia, JB Lippincott, 1977.)

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