Data have been presented on dynamic changes in plasma insulin concentrations in normal and pathologic states and the relationship between plasma insulin levels and insulin secretory rates has been considered. Hypoglycemia secondary to absolute or relative hyperinsulinism can follow stimulation by glucose or pharmacologic agents, abnormal sensitivity to leucine, uncontrolled secretion by insulinomas and exogenous insulin administration; hypoglycemianot associated with significant elevation of plasma insulin may occur with nonpancreatic neoplasms, fructose intolerance, idiopathic hypoglycemia of childhood and hepatic malfunction. The occasional failure of the body's counterregulatory mechanisms to alleviate hypoglycemia in the absence of significant hyperinsulinism may be attributable to different factors in individual cases and requires independent study.

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