Home
HelpTest Code SOFT: Z0079 Insulin, Serum
Additional Codes
| Ordering Mnemonic | Mayo Test ID |
|---|---|
| EPIC NAME: INSULIN LEVEL | INS |
EPIC CODE: LAB575
Reporting Name
Insulin, SUseful For
Diagnosing insulinoma, when used in conjunction with proinsulin and C-peptide measurements
Management of diabetes mellitus
Method Name
Electrochemiluminescence Immunoassay (ECLIA)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
Patients on insulin therapy may develop anti-insulin antibodies. These antibodies may interfere in the assay system, causing inaccurate results. In such individuals, measurement of free insulin INSFT / Insulin, Free and Total, Serum should be performed.
Specimen Required
Patient Preparation:
1. Patient should be fasting.
2. For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Avoid hemolysis
2. Label specimens with corresponding collection times.
3. Centrifuge and aliquot serum into plastic vial within 2 hours of collection.
Additional Information: If multiple specimens are drawn, send separate order for each specimen.
Specimen Minimum Volume
0.75 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 180 days | |
| Refrigerated | 7 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Autopsy specimen | Reject |
Reference Values
2.6-24.9 mcIU/mL
For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Day(s) Performed
Monday through Friday
CPT Code Information
83525
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| INS | Insulin, S | 27873-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| INS | Insulin, S | 27873-9 |
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.Clinical Information
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).
Interpretation
During prolonged fasting, when the patient's glucose level is reduced to <40 mg/dL, an 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.
Cautions
Human antimouse antibodies (HAMA) may interfere with the assay.
This assay has 100% cross-reactivity with recombinant human insulin (Novolin R and Novolin N). It does not recognize other commonly used analogues of injectable insulin (ie, insulin lispro, insulin aspart, and insulin glargine).
Clinical Reference
1. Threatte GA, Henry JB: Carbohydrates. In: Henry JB, ed. Clinical Diagnosis and Management by Laboratory Methods. 19th ed. WB Saunders Company; 1996:194-207
2. Sacks DB: Diabetes mellitus. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics 6th ed. Elsevier; 2018:1160-1200
Method Description
This insulin method is a sandwich electrochemiluminescence immunoassay that employs a biotinylated monoclonal insulin-specific antibody and a monoclonal insulin-specific antibody. Insulin in the specimen reacts with both the biotinylated monoclonal insulin-specific antibody (mouse) and the monoclonal insulin-specific antibody (mouse) labeled with a ruthenium complex, forming a sandwich complex. Streptavidin-coated microparticles are added and the mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Unbound substances are then removed with ProCell. Application of voltage to the electrode induces the chemiluminescent emission, which is then measured.(Package insert: Roche Insulin reagent. Roche Diagnostics; V1 10/2010)