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Fasting Insulin Levels Normal Range Pmol/l

What's The Ideal Fasting Insulin Level?

What's The Ideal Fasting Insulin Level?

[2013 update. I'm leaving this post up for informational purposes, but I think it's difficult to determine the "ideal" insulin level because it depends on a variety of factors including diet composition. Also, insulin assays are not always comparable to one another, particularly the older assays, so it's difficult to compare between studies] Insulin is an important hormone. Its canonical function is to signal cells to absorb glucose from the bloodstream, but it has many other effects. Chronically elevated insulin is a marker of metabolic dysfunction, and typically accompanies high fat mass, poor glucose tolerance (prediabetes) and blood lipid abnormalities. Measuring insulin first thing in the morning, before eating a meal, reflects fasting insulin. High fasting insulin is a marker of metabolic problems and may contribute to some of them as well. Elevated fasting insulin is a hallmark of the metabolic syndrome, the quintessential modern metabolic disorder that affects 24% of Americans (NHANES III). The average insulin level in the U.S., according to the NHANES III survey, is 8.8 uIU/mL for men and 8.4 for women (2). Given the degree of metabolic dysfunction in this country, I think it's safe to say that the ideal level of fasting insulin is probably below 8.4 uIU/mL. Let's dig deeper. What we really need is a healthy, non-industrial "negative control" group. Fortunately, Dr. Staffan Lindeberg and his team made detailed measurements of fasting insulin while they were visiting the isolated Melanesian island of Kitava (3). He compared his measurements to age-matched Swedish volunteers. In male and female Swedes, the average fasting insulin ranges from 4-11 uIU/mL, and increases with age. From age 60-74, the average insulin level is 7.3 uIU/mL. In contrast, the range on Kit Continue reading >>

Insulin Resistance/t2 Diabetes: Map Your Test Results

Insulin Resistance/t2 Diabetes: Map Your Test Results

The following post is from Step Three of The Blood Code: Unlock the secrets of your metabolism. I know this seems complicated at first sight but once you know your placement, you can act accordingly and move toward your metabolic recovery. Are You Insulin Resistant? You show no insulin resistance if your Blood Code reveals: Fasting glucose is between 75–95 mg/dL (4.2–5.3 mmol/L). TG:HDL ratio is near 1.0, +/- 0.5. Fasting insulin is between 3–8 uIU/mL (18–48 pmol/L). HgbA1C level is less than 5.6% (<37 mmol/mol). Glucose/insulin as HOMA-IR is near 1 (.5–1.5). Your total body fat is <28% for men and <32% for women. You show slight insulin resistance if you have two or more of the following: Fasting glucose is greater than 95 mg/dL (5.3 mmol/L). TG:HDL ratio is greater than 2. Fasting insulin is greater than 8 uIU/mL (>48 pmol/L). HgbA1C level is greater than 5.5% (>36 mmol/mol). HOMA-IR is greater than 1.5. The skin fold at your hip is greater than that at your triceps (by at least 5 mm). You show moderate insulin resistance if you have three or more of the following: Fasting glucose is greater than 100 mg/dL (>5.6 mmol/L). TG:HDL ratio is 3 or greater. Fasting insulin is greater than 10 uIU/mL (>60 pmol/L). HgbA1C level is greater than 5.7% (>39 mmol/mol). HOMA-IR is greater than 2.5. The skin fold at your hip measures near twice that at your triceps. You show severe insulin resistance if you have three or more of the following: Fasting glucose is greater than 110 mg/dL (>6.1 mmol/L). Greater than 125 mg/dL (>7.0 mmol/L) is diabetes.* TG:HDL ratio is greater than 4. Fasting insulin is greater than 12 uIU/mL (>72 pmol/L). HgbA1C level is greater than 6.0% (>42 mmol/mol). Greater than 6.4% (>46 mmol/mol) is diagnostic of diabetes.* HOMA-IR is greater than 3. The Continue reading >>

Blood Sciences Test

Blood Sciences Test

C Peptide (Plasma) Specimen Plasma EDTA 2.7 ml tube or centrifuged serum-gel tube. Special Instructions Must be sent to arrive to us at the laboratory within 24 h from collection. If the sample cannot be sent to us within 24 h from sample collection, centrifuge, aliquot and freeze sample and send specimen frozen. Units pmol/L Test Usage C-peptides are fragments derived from endogenous, but not exogenous, insulin and therefore may be used to assess endogenous insulin secretion even in patients who receive exogenous insulin therapy. C-peptide testing is used in the investigation of unexplained hypoglycaemia and in the management of patients with insulin treated diabetes. Investigation of hypoglycaemia: A C-peptide concentration greater than 300 pmol/L during a hypoglycaemic episode (concurrant glucose <2.5 mmol/L), is inappropriately high suggesting insulinoma or sulfonylurea ingestion. C-peptide is considered appropriately supressed if less than 94 pmol/L during hypoglycaemia. Indeterminate values (94-300 pmol/L) require measurement of beta hydroxybutyrate to determine if hyperinsulinism is present. Management of Insulin treated diabetes C-peptide measurement can assist classification and management of patients who have insulin treated diabetes. Clinical thresholds and interpretation for patients with insulin treated diabetes are shown in table 1 below. As the main clinical role of the C-peptide test in diabetes is identifying or excluding very severe insulin deficiency (present in longstanding Type 1 diabetes and associated with an absolute requirement for insulin) the role of C-peptide testing in non-insulin treated patients is limited General interpretation Availability Local test Turnaround Time 7 days Cannot be added on to an existing request REFERRALS We welcome re Continue reading >>

Insulin Resistance

Insulin Resistance

Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to the hormone insulin. The body produces insulin when glucose starts to be released into the bloodstream from the digestion of carbohydrates in the diet. Normally this insulin response triggers glucose being taken into body cells, to be used for energy, and inhibits the body from using fat for energy. The concentration of glucose in the blood decreases as a result, staying within the normal range even when a large amount of carbohydrates is consumed. When the body produces insulin under conditions of insulin resistance, the cells are resistant to the insulin and are unable to use it as effectively, leading to high blood sugar. Beta cells in the pancreas subsequently increase their production of insulin, further contributing to a high blood insulin level. This often remains undetected and can contribute to the development of type 2 diabetes or latent autoimmune diabetes of adults.[1] Although this type of chronic insulin resistance is harmful, during acute illness it is actually a well-evolved protective mechanism. Recent investigations have revealed that insulin resistance helps to conserve the brain's glucose supply by preventing muscles from taking up excessive glucose.[2] In theory, insulin resistance should even be strengthened under harsh metabolic conditions such as pregnancy, during which the expanding fetal brain demands more glucose. People who develop type 2 diabetes usually pass through earlier stages of insulin resistance and prediabetes, although those often go undiagnosed. Insulin resistance is a syndrome (a set of signs and symptoms) resulting from reduced insulin activity; it is also part of a larger constellation of symptoms called the metabolic syndrome. Insuli Continue reading >>

Insulin, Plasma

Insulin, Plasma

Test Identifier Information Registration Code INS Method Roche Cobas e411 after PEG precipitation of immunoglobulins. Diagnostic Use / Indications See Guidelines for the measurement of plasma insulin This test can only measure native human insulin. Insulinoma – The concentration of insulin is disproportionately high in relation to the concurrent low, (<2.5mmol/L) fasting plasma glucose level. See Turner et al. Ideally insulin levels are measured during an hypoglycaemic episode and/or after a carefully supervised 48-72 hour fast.The secretion of ProInsulin and C-Peptide may also be increased in patients with insulinoma. These assays can be carried out by special arrangement with Endolab.Tests of insulin suppressability may be undertaken using infusion of insulin and measurement of C-Peptide levels when hypoglycaemic.Hepatic vein insulin levels can be measured to help localise site of pancreatic islet cell adenoma after selective injections of calcium via branches of the celiac axis artery.Early diagnosis of diabetes – the first phase of insulin release which occurs 3 to 5 minutes after the intravenous injection of 25g glucose, is absent or blunted. Subsequent insulin secretion may be normal or increased. A raised fasting insulin value or an excessive response to glucose may suggest insulin resistance such as occurs in obesity, acromegaly, Cushing’s Syndrome, etc.Note: For clinical purposes the conventional 75g oral glucose tolerance test or 25g IV glucose tolerance test gives adequate information and plasma insulin determinations are generally unnecessary.R C Turner, N W Oakley and J D N Nabarro, BMJ. 1971: Vol 2, p 132 - 135 External Price $33.79(Exclusive of GST) Specimen Collection Pre-Testing Requirements Fasted overnight. Simultaneous glucose levels are needed Continue reading >>

The One Number That May Best Predict Your Risk Of Sudden Death

The One Number That May Best Predict Your Risk Of Sudden Death

There are seven numbers you should track if you want to monitor your health—five are determined by simple blood tests, and the other two you can determine at home The five blood tests you should regularly obtain are fasting insulin, cholesterol/HDL ratio, serum ferritin, uric acid, and vitamin D; two good indicators for assessing your overall “metabolic fitness” and heart attack risk are your percentage body fat and your waist-to-hip ratio Optimizing your vitamin D level is crucial for health because vitamin D influences about 3,000 of your 30,000 genes, helping to prevent a multitude of diseases from cardiovascular disease to the common cold Minimizing dietary sugar, especially fructose, will go a long way toward optimizing nearly ALL seven of these numbers—if you could do only one thing, this would be the one! By Dr. Mercola The Globe and Maili recently published an article outlining "the 5 numbers that most impact your health." I think they have the right idea, but but I disagree with their test selections. If you really want to monitor your health, I believe the numbers you should be tracking are the seven listed in the table below. These are far more important than tracking your total cholesterol, blood pressure, or BMI, as recommended by the Globe and Mail. Let's take a closer look at these values and what they may reveal about your health. 1. Fasting Insulin (I) 2. Cholesterol/HDL Ratio (C) 3. Percentage Body Fat (F) 4. Serum Ferritin (F) 5. Waist/Hip Ratio (WH) 6. Uric Acid Level (U) 7. Vitamin D Level (D) 1. Fasting Insulin Level Your fasting insulin level reflects how healthy your blood glucose levels are over time. Insulin helps sugar move from your blood into your cells, where it can be used or stored. Chronically elevated blood glucose leads to insu Continue reading >>

Do You Know Your Insulin Level?

Do You Know Your Insulin Level?

People often keep close watch on their glucose numbers. But how many of us know our insulin level? Dr. Joseph Mercola says fasting insulin is “the number that may best predict your sudden death.” Sounds important. But what does it mean? Our bodies need some circulating insulin at all times, even when we don’t eat. Otherwise, our livers keep making glucose and dumping it into the blood. Livers do this to prevent blood glucose from going too low. So a fasting insulin level should never be 0, which it might be in a person with untreated Type 1. It shouldn’t go below 3. But a high insulin level is just as problematic. A high insulin level is a sign of insulin resistance or prediabetes. It can also signify early-stage Type 2. According to Dr. Mercola, too much insulin promotes weight gain by storing fat. It promotes insulin resistance, lowers magnesium levels, and increases inflammation. It also tends to lower HDL (“good”) cholesterol and raise levels of LDL (“bad”) cholesterol. All of these increase the risk of diabetes and heart disease. It may be that high insulin levels come before insulin resistance and help cause it. If you already have diabetes, why should you know your insulin level? Mainly, it helps diagnose what is happening with you. Your blood glucose may be high, but how much of the problem is too little insulin? How much is insulin resistance? A fasting insulin level test is valuable in several situations: • Diagnosing prediabetes and metabolic syndrome. “Prediabetes” is one result of insulin resistance. Insulin resistance causes high cholesterol, high glucose, and high blood pressure. A high level of fasting insulin indicates insulin resistance and can encourage a person to make changes to lower it. • Separating Type 2 from LADA (latent Continue reading >>

Specific Insulin And Proinsulin In Normal Glucose Tolerant First-degree Relatives Of Niddm Patients.

Specific Insulin And Proinsulin In Normal Glucose Tolerant First-degree Relatives Of Niddm Patients.

Specific insulin and proinsulin in normal glucose tolerant first-degree relatives of NIDDM patients. Universidade Federal de So Paulo, Escola Paulista de Medicina, Brasil. In order to identify early abnormalities in non-insulin-dependent diabetes mellitus (NIDDM) we determined insulin (using an assay that does not cross-react with proinsulin) and proinsulin concentrations. The proinsulin/insulin ratio was used as an indicator of abnormal beta-cell function. The ratio of the first 30-min increase in insulin to glucose concentrations following the oral glucose tolerance test (OGTT; I30-0/G30-0) was taken as an indicator of insulin secretion. Insulin resistance (R) was evaluated by the homeostasis model assessment (HOMA) method. True insulin and proinsulin were measured during a 75-g OGTT in 35 individuals: 20 with normal glucose tolerance (NGT) and without diabetes among their first-degree relatives (FDR) served as controls, and 15 with NGT who were FDR of patients with NIDDM. The FDR group presented higher insulin (414 pmol/l vs 195 pmol/l; P = 0.04) and proinsulin levels (19.6 pmol/l vs 12.3 pmol/l; P = 0.03) post-glucose load than the control group. When these groups were stratified according to BMI, the obese FDR (N = 8) showed higher fasting and post-glucose insulin levels than the obese NGT (N = 9) (fasting: 64.8 pmol/l vs 7.8 pmol/l: P = 0.04, and 60 min post-glucose: 480.6 pmol/l vs 192 pmol/l: P = 0.01). Also, values for HOMA (R) were higher in the obese FDR compared to obese NGT (2.53 vs 0.30; P = 0.075). These results show that FDR of NIDDM patients have true hyperinsulinemia (which is not a consequence of cross-reactivity with proinsulin) and hyperproinsulinemia and no dysfunction of a qualitative nature in beta-cells. Continue reading >>

Fasting Insulin

Fasting Insulin

A blood test for fasting insulin can be one of the most important that you get. It’s important because it shows the degree of insulin resistance: the higher the number, the more insulin resistant. A very high number generally means type 2 diabetes. A number merely higher than normal can signify metabolic syndrome or pre-diabetes. Hyperinsulinemia, or too much insulin in the blood, is one of the main causes of chronic disease in the modern world, including heart disease, cancer, kidney disease, and of course diabetes. Being sedentary leads to insulin resistance, and exercise can prevent it. Insulin resistance is strongly associated with obesity, but normal weight people, especially those who are skinny-fat, can have it too. A diet high in sugar and refined carbohydrates, especially when combined with seed oils, leads to hyperinsulinemia and insulin resistance. My fasting insulin test Doctors don’t routinely test for fasting insulin; they normally do so only if they suspect diabetes. I’ve had a few tests of fasting blood glucose that were high, in the range of 100 to 110. That’s an odd result, because I eat a low-carbohydrate diet and lift weights, and have a body fat percentage that I don’t know exactly but is likely <15%. It’s probably due to the so-called dawn phenomenon, or physiological insulin resistance, which is normal. When on a low-carbohydrate diet, the liver can become insulin resistant in order to make glucose for the rest of the body. To be honest, the causes of the dawn phenomenon are not fully elucidated, and experts give varying explanations. But the fact is that many people who eat low-carb report it. Another reason for a high fasting glucose can be stress and cortisol; if you go for a blood draw on a morning when you’re rushing off to work Continue reading >>

Test Id: Ins Insulin, Serum

Test Id: Ins Insulin, Serum

Diagnosing insulinoma, when used in conjunction with proinsulin and C-peptide measurements Management of diabetes mellitus Insulin is a hormone produced by the beta cells of the pancreas. It regulates the uptake and utilization of glucose and is also involved in protein synthesis and triglyceride storage. Type 1 diabetes (insulin-dependent diabetes) is caused by insulin deficiency due to destruction of insulin-producing pancreatic islet (beta) cells. Type 2 diabetes (noninsulin dependent diabetes) is characterized by resistance to the action of insulin (insulin resistance). Insulin levels may be increased in patients with pancreatic beta cell tumors (insulinoma). During prolonged fasting, when the patient's glucose level is reduced to <40 mg/dL, elevated insulin level plus elevated levels of proinsulin and C-peptide suggest insulinoma. Insulin levels generally decline in patients with type 1 diabetes mellitus. In the early stage of type 2 diabetes, insulin levels are either normal or elevated. In the late stage of type 2 diabetes, insulin levels decline. In normal individuals, insulin levels parallel blood glucose levels. To compare insulin and C-peptide concentrations (ie, insulin to C-peptide ratio): -Convert insulin to pmol/L: insulin concentration in mcIU/mL x 6.945 = insulin concentration in pmol/L. -Convert C-peptide to pmol/L: C-peptide concentration in ng/mL x 331 = C-peptide concentration in pmol/L. Twelve hours before this blood test do not take multivitamins or dietary supplements containing biotin or vitamin B7, which are commonly found in hair, skin, and nail supplements and multivitamins. Human antimouse antibodies (HAMA) may interfere with the assay. Patients on insulin therapy may develop anti-insulin antibodies. These antibodies may interfere in the ass Continue reading >>

Insulin Resistance Diagnosis

Insulin Resistance Diagnosis

Insulin resistance describes the body's lack of sensitivity to the hormone insulin, meaning body cells such as the muscle, fat and liver cells are not adequately stimulated to take up glucose from the blood, even when insulin levels are high. This under-utilization of blood glucose results in hyperglycemia or a raised blood sugar level. Tests for diagnosing insulin resistance include: Fasting blood sugar and postprandial blood sugar - Blood sugar is almost always raised in people with insulin resistance. Fasting insulin assessment - In a healthy person who has fasted for 6 to 8 hours (usually overnight), the insulin level is approximately 60 pmol/L. A level higher than this is considered indicative of insulin resistance. Glucose tolerance testing (GTT) - For a glucose tolerance test, a person fasts for 8 to 12 hours (usually overnight) and is then given a 75 gram oral dose of glucose. After two hours, the blood levels of glucose are measured. In a healthy person, the blood sugar level after two hours is usually less than 7.8 mmol/L (140 mg/dl). A blood sugar level between 7.8 and 11.0 mmol/dl (140 to 197 mg/dl), however, indicates impaired glucose tolerance. If the level is over 11.1 mmol/dl (200 mg/dl), diabetes mellitus is diagnosed. Modified insulin suppression test - For this test, patients are given 25 mcg of octreotide (an inhibitor of insulin and glucagon) over 3 to 5 minutes and are then infused with somatostatin (0.27 μgm/m2/min) to suppress the release of insulin and glucose into the blood. Next, the patient is administered insulin and 20% glucose and a series of blood sugar tests are then performed and the values averaged out to give the steady-state plasma glucose (SSPG) level. An SSPG greater than 150 mg/dl indicates insulin resistance. Other measures of i Continue reading >>

Physiological Range Of Insulin Secretion And Concentration

Physiological Range Of Insulin Secretion And Concentration

The physiological insulin secretion (suppression) and thus insulin levels in serum by means of complex regulatory mechanisms of glucose homoeostasis effectively prevent fasting or spontaneous hypoglycemia, e.g. the lowering of blood glucose concentrations below the critical level of 50 mg/dL, required for "normal" function of the central nervous system, the brain. This minimal concentration of blood glucose is required by the brain in order to meet energetic and caloric needs consuming an hourly average of 6 grams of glucose. Between meals insulin levels demonstrate a highly variable sharp rise of short duration (30 to 60 minutes postprandially) dependent upon the amount and quality of carbohydrates consumed. A concentration range of 50 - 100 µU/mL (300 - 600 pmol/L) is regularly found, thus insulin belongs to the few hormones demonstrating a physiological range of concentrations by a factor of 20-30. In parallel the blood glucose concentration fluctuates between 60 mg/dL and 180 mg/dL maximally (3.3 - 10 mM) clearly dependent upon the highly variable individual insulin sensitivity. Normal suppression of insulin secretion Adaequate suppression of insulin secretion during prolonged fasting is achieved when the insulin concentration in serum samples drops below 5 µU/mL ( < 30 pmol/L ) during normal blood glucose levels in the range of 50 mg/dL. In case of adaequate suppression of insulin secretion the concentration of proinsulin should be measured in the range of a few pmol/l close to the detection limit: < 5 pmol/l Adaequate suppression of the C-peptide concentration is achieved with parallel levels < 0.6 ng/ml (= < 0.2 nmol/l or < 200 pmol/l) If the blood glucose concentration during assured fasting (positive acetonuria) definitely is > 50 mg/dL (55-70 mg/dL), the ins Continue reading >>

How To Test For Insulin Resistance: Your Comprehensive Guide

How To Test For Insulin Resistance: Your Comprehensive Guide

This guide is dedicated to Dr.Joseph Kraft MD, a pioneer in the development of laboratory assays to accurately test for insulin resistance before the development of diabetes. The amazing Dr. Kraft just recently passed away in 2017 at the age of 95. His contributions to the field of metabolic and cardiovascular health were under-appreciated during his time but have vast implications today! I’ve been told that my Blood Sugar is Normal! So I’m Not Insulin Resistant, Right? In most medical practices, it is typical to test patients for blood markers of diabetes. Unfortunately, this type of thinking is rather dangerous as the vast majority of people who exhibit signs and symptoms of insulin resistance test negative for diabetes! Signs and Symptoms of Insulin Resistance Increased abdominal circumference Easy weight gain Difficult weight loss Acanthosis nigricans (dark velvety skin behind the neck or under the arms) Skin tags Fatty liver Why are so many patients with these clear signs and symptoms of insulin resistance testing negative for the most common assays for diabetes? The answer is simple! The wrong tests are being recommended. What’s the Difference Between Diabetes and Insulin Resistance? Rather than a condition that develops overnight, the onset of type two diabetes is a lengthy process that takes many, many years to manifest. It begins with insulin resistance, often starting decades before the high blood sugar levels characteristic of a diabetic emerge. Insulin resistance is characterized by hyperinsulinemia – the secretion of higher than normal amounts of insulin either after eating, or continuously even when fasting. Insulin is an important hormone – without which we would quickly die. It is released after we eat, and tells our bodies what to do with the Continue reading >>

Insulin: Reference Range, Interpretation, Collection And Panels

Insulin: Reference Range, Interpretation, Collection And Panels

Insulin is an anabolic hormone that promotes glucose uptake, glycogenesis, lipogenesis, and protein synthesis of skeletal muscle and fat tissue through the tyrosine kinase receptor pathway. In addition, insulin is the most important factor in the regulation of plasma glucose homeostasis, as it counteracts glucagon and other catabolic hormonesepinephrine, glucocorticoid, and growth hormone. Table 1. Reference Range of Insulin Levels [ 1 ] (Open Table in a new window) A standard insulin test is positive for endogenous insulin and exogenous insulin. In addition, there is a minimal cross-reaction with proinsulin and insulinlike growth factors 1 and 2, with the degree of variability depending on the brand of the testing toolkit and technique used. Insulin testing is used to assist in identifying causes of hypoglycemia (plasma glucose levels < 55 mg/dL), especially upon signs and symptoms of hypoglycemia (neurohypoglycopenic and autonomic symptoms). In this scenario, a 72-hour fasting test is performed. [ 2 ] Insulinoma: High insulin and C-peptide levels Nonbeta cell tumors: Low insulin and C-peptide levels and high insulinlike growth factor 2 level [ 3 ] Excessive insulin administration: High insulin levels and low C-peptide levels Insulin secretagogue administration (sulfonylurea and glinides): High insulin and C-peptide levels Congenital hyperinsulinism (mutation in insulin-secreting gene): High insulin and C-peptide levels Autoimmunity to insulin or insulin receptor (common in patients receiving insulin or those who have autoimmune diseases such as systemic lupus erythematosus [SLE] or Hashimoto thyroiditis): Postprandial insulin is bound to antibodies and dissociated 1 hour later, resulting in an extremely elevated insulin level and high insulintoC-peptide ratio [ 4 ] T Continue reading >>

Proinsulin

Proinsulin

Minimum: Preferred Minimum: 1.5 mL of EDTA plasma. Draw blood in an ice-cooled lavender-top (EDTA) tube(s) from a fasting patient. Absolute Minimum: 0.65 mL of EDTA plasma. Draw blood in an ice-cooled lavender-top (EDTA) tube(s) from a fasting patient. Interpretive Data: Normal individuals will have proinsulin concentrations below the upper limit of the normal fasting reference range (20 pmol/L) when hypoglycemic (blood glucose <45-60 mg/dL). Conversely, most (>80%) insulinoma patients will have proinsulin concentrations above the upper limit of the reference range. The sensitivity and specificity for a diagnosis of insulinoma during hypoglycemia are approximately 75% and near 100%, respectively, at the 20 pmol/L cutoff. A higher sensitivity (>95%) can be achieved using a 5 pmol/L cutoff, and this is the cutoff recommended by the reference laboratory. However, the lower cutoff results in a reduced specificity (approximately 40%), emphasizing the need for a combination of different tests to assure accurate biochemical diagnosis. Patients with PC1/3 deficiency have low, or sometimes undetectable, insulin levels and substantially elevated proinsulin levels, exceeding the upper limit of the reference range substantially in the fasting state and rising even higher after food intake. Many other hormonal abnormalities are also present, including cortisol deficiency (because of lack of processing of pro-opiomelanocortin to adrenocorticotropic hormone and other peptides), infertility and, often, morbid obesity. This assay demonstrates no cross-reactivity with insulin or C-peptide. Comments: Useful: As part of the diagnostic workup of suspected insulinoma. As part of the diagnostic workup of patients with suspected PC1/3 deficiency. As part of the diagnostic workup of patients wi Continue reading >>

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