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Clinical insights into the safety and utility of the insulin tolerance test (ITT) in the assessment of the hypothalamo-pituitary-adrenal axis.Finucane, Francis M; Liew, Aaron; Thornton, Evan; Rogers, Barbara; Tormey, William; Agha, Amar; Academic Department of Endocrinology, Beaumont Hospital and the RCSI Medical School, Dublin, Ireland. (2008-10)The insulin tolerance test (ITT) is the gold standard for assessing GH and cortisol production in pituitary disease. However, areas of uncertainty remain regarding its safety in older people, the optimal duration of the test and its performance in insulin resistant states. Whether basal cortisol concentration can reliably predict an adequate adrenal response to hypoglycaemia remains to be determined.