CLINICAL MEDICINE

Detailed explanation-1: -The insulin stress test (IST) (or insulin tolerance test, ITT) has traditionally been the ‘gold standard’ test to assess the adequacy of the ACTH–adrenal axis. After adequate hypoglycaemia (blood glucose <2.2 mmol/L), a normal rise of plasma cortisol (traditionally to >550 nmol/L) excludes ACTH and cortisol deficiency.

Detailed explanation-2: -Insulin Tolerance Test The ITT has traditionally been accepted as the gold standard test for the assessment of adult GHD, with a GH cut-point of 3-5 g/L when adequate hypoglycemia (blood glucose < 40 mg/dL) is achieved (8, 16, 17).

Detailed explanation-3: -The insulin stress test involves lowering your blood sugar using insulin to artificially induce a stress response. Low blood sugar levels should stimulate the pituitary gland to release certain hormones and this test allows us to check that your growth hormone and cortisol response is working.

Detailed explanation-4: -Macimorelin is indicated for diagnosis of adult growth hormone deficiency.

Detailed explanation-5: -What is an IGF-1 test? This test measures the amount of IGF-1 (insulin-like growth factor 1) in your blood. IGF-1 is a hormone that manages the effects of growth hormone (GH) in your body. Together, IGF-1 and GH promote normal growth of bones and tissues.