| Whipple Triad |
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#Symptoms known or likely to be caused by hypoglycemia #A low glucose measured at the time of the symptoms #Relief of symptoms when the glucose is raised to normal HISTORY The criteria date back to the 1930's, when it had been discovered that a few patients with hypoglycemic symptoms (such as shakiness, s as an indirect measure of blood Glucose , there was no way to measure Hormone s and metabolites such as Insulin , and no Imaging Procedures for internal Organ s such as the Pancreas . Allen O. Whipple was a well-known surgeon who had pioneered pancreatic surgery. In an article entitled "The surgical therapy of hyperinsulinism", in ''J Internat Chir'' 3:237-276 (1938), he proposed that no pancreatic surgery to look for an insulinoma be performed unless these criteria were met. CURRENT USE OF THE TRIAD The use and significance of the criteria have evolved over the last century as our understanding of the many forms of hypoglycemia has increased and our Diagnostic Test s and imaging procedures have improved. Whipple's criteria are no longer used to justify surgical exploration for an insulinoma, but to separate "true hypoglycemia" in which a low glucose can be demonstrated from a variety of other conditions (e.g., Idiopathic Postprandial Syndrome ) in which symptoms suggestive of hypoglycemia occur but low glucose levels cannot be demonstrated. The criteria are now invoked far more often by Endocrinologist s than by surgeons. The reliability of the criteria for this purpose has been a subject of contention among physicians. SEE ALSO |
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