The essential conditions are: The use and significance of the criteria have evolved over the last century as understanding of the many forms of hypoglycaemia has increased and diagnostic tests and imaging procedures have improved.
Whipple's criteria are no longer used to justify surgical exploration for an insulinoma, but to separate "true hypoglycaemia" (in which a low glucose can be demonstrated) from a variety of other conditions (e.g., idiopathic postprandial syndrome) in which symptoms suggestive of hypoglycaemia occur, but low glucose levels cannot be demonstrated.
[4] The criteria date back to the 1930s, when a few patients with hypoglycaemic symptoms (such as shakiness, syncope, or sweating) due to hypoglycaemia were found to be cured by surgery to remove an insulinoma, but a large proportion of people with symptoms suggestive of hypoglycaemia apparently had no need of surgery.
Diagnostic testing was rudimentary; beyond a crude assay for reducing substances as an indirect measure of blood glucose, no way had yet been found to measure hormones and metabolites such as insulin, with no imaging procedures for internal organs such as the pancreas.
[citation needed] Allen Whipple was a well-known surgeon who had pioneered pancreatic surgery.