Failure of glucagon to increase after arginine stimulation is seen in glucagon deficiencies such as cystic fibrosis and chronic pancreatitis.
This test is of rare clinical utility.
After fasting overnight, an IV infusion of 0.5 g arginine/kg (not >30 g) should be given over 30 minutes. Fasting samples should be drawn at 15, 30, 45, and 60 minutes.
Normal range: peak glucagon concentration at 30 minutes: 100 " “1,500 pg/mL.
Limitations
Arginine also stimulates insulin.
There is an exaggerated response in diabetes, chronic renal failure, and liver failure.