Whipple’s triad
Whipple’s triad is a collection of three criteria (called Whipple’s criteria) that suggest a patient’s symptoms result from hypoglycemia that may indicate insulinoma. The triad is stated in various versions, but the essential conditions are:
- Symptoms known or likely to be caused by hypoglycemia especially after fasting or heavy exercise
- A low plasma glucose measured at the time of the symptoms
- Relief of symptoms when the glucose is raised to normal
Exam Question
- Whipple’s triad includes symptoms of hypoglycaemia, low blood glucose measured at the time of symptoms and symptoms resolved on correction of hypoglycemia
- Insulinomas are a 13 cell endocrinal tumour of the pancreas.
- The symptoms are produced due to excessive secretion of insulin causing hypoglycemia
- Most of the insulinomas are solitary and benign.
- Only about 10-15 % of insulinomas are malignant. (Keep in mind that all other endocrine tumours of pancreas are usually malignant).
Classic diagnostic criteria is Whipple’s triad
- Signs and symptoms of hypoglycemia during fasting.
- Blood glucose below 2.8 mmol/L (50 mg/dl) during symptomatic episodes.
- Relief of symptoms by intravenous administration of Glucose.
Classical presentation of insulinoma (Whipple’s triad)
- Fasting hypoglycemia
- Plasma glucose levels < 2.8 mmo1/1
- Relief of symptoms on intravenous administration of glucose
Don’t Forget to Solve all the previous Year Question asked on Whipple’s triad
