Unexplained hypoglycemia
Elevate understanding of causes with precise insulin analog testing
For patients with unexplained hypoglycemia, evaluating insulin’s role in blood glucose regulation is an essential part of the diagnostic workup.
However, immunoassay testing, which is the conventional approach for measuring insulin levels, is problematic for several reasons. These include:
- Varying levels of cross reactivity with and inability to differentiate between natural human insulin and insulin analogs.
- Falsely high or falsely low results due to interferences from heterophile antibodies, biotin, hemolysis, and other factors.
A highly specific alternative for assessing insulin levels is liquid chromatography-high-resolution accurate mass-mass spectrometry (LC-HRAM-MS). This method can accurately and simultaneously measure multiple insulin analogs, including human insulin.
Unexplained hypoglycemia test menu
Insulin analog testing
Mayo Clinic Laboratories’ first-in-class insulin analog assay uses LC-HRAM-MS to differentiate between and directly measure human insulin and four insulin analogs — aspart, lispro, glulisine, and glargine — from a single blood sample.
In addition to clarifying cases of unexplained hypoglycemia when insulin immunoassay results do not align with a patient’s clinical presentation, results can also be used to monitor treatment compliance. Further, this highly specific assay is uniquely suited to assist in cases of suspected factitious hypoglycemia. In these diagnostically challenging, sensitive cases, test results can clarify insulin exposure that is not acknowledged or understood due to covert insulin use.
By providing specific, accurate, and definitive measurements of both natural insulin and insulin analogs, test results can help physicians confidently rule in or rule out potential causes of unexplained hypoglycemia, reduce time to diagnosis, and guide patient management.
Key testing
- INSAL | Insulin Analogs, Serum
- Uses LC-HRAM-MS to detect and quantify native human insulin and insulin analogs in serum.
- Detects native human insulin and four insulin analogs: aspart, lispro, glulisine, and glargine.
- Provides an alternative testing method for insulin measurements when immunoassay test results do not align with the clinical presentation.
- Helps assess factitious hypoglycemia from misuse or surreptitious administration of insulin analogs.
- Monitors treatment adherence of prescribed insulin therapy.
Highlights
Learn more about how Mayo Clinic Laboratories first-in-class insulin analogs assay uses liquid chromatography-high resolution mass spectrometry to provide clinicians with a highly specific way to identify and differentiate human insulin from multiple synthetic insulin analogs from a single blood sample. By overcoming the limitations of traditional immunoassays, the test delivers greater diagnostic clarity in complex hypoglycemia cases, helping clinicians reach accurate diagnoses faster and guide more effective patient care.