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HelpTest ID HYPOG Hypoglycemic Agent Screen, Serum
Useful For
Evaluation of suspected insulinoma characterized by hypoglycemia and increased plasma insulin concentration.
Detecting drugs that stimulate insulin secretion
If hypoglycemia is the result of 1 of these drugs, the test will detect the drug at physiologically significant concentrations in serum during an episode of hypoglycemia.
Drugs detected by this procedure are:
-The first-generation sulfonylureas-acetohexamide, chlorpropamide, tolazamide, and tolbutamide
-The second-generation sulfonylureas--glimepiride, glipizide, and glyburide
-The meglitinide-repaglinide
Drugs designed to make tissues more sensitive to insulin that do not induce hypoglycemia, such as pioglitazone, rosiglitazone, and troglitazone (recently withdrawn from the United States market) are not included in this screen test.
Drugs that lower blood glucose through mechanisms not related to stimulation of insulin secretion, such as acarbose, metformin, and miglitol are not included in this screen test.
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Hypoglycemic Agent Scrn, SSpecimen Type
Serum RedCollection Container/Tube: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Specimen Minimum Volume
1.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Frozen (preferred) | 14 days |
| Ambient | 14 days | |
| Refrigerated | 14 days |
Clinical Information
The metabolic and hormonal profiles of insulinoma and sulfonylurea-induced hypoglycemia are identical. Therefore, in the evaluation of the hypoglycemic patient, the possible use of oral hypoglycemic agents as the cause for low blood glucose and elevated plasma insulin must be considered. Absence of hypoglycemic drugs in blood serum during an episode of low blood glucose should be demonstrated before considering pancreatic exploration for suspected insulinoma.
Reference Values
ACETOHEXAMIDE
Negative: <1,000 ng/mL
CHLORPROPAMIDE
Negative: <1,000 ng/mL
TOLAZAMIDE
Negative: <20 ng/mL
TOLBUTAMIDE
Negative: <50 ng/mL
GLIMEPIRIDE
Negative: <20 ng/mL
GLIPIZIDE
Negative: <3 ng/mL
GLYBURIDE
Negative: <3 ng/mL
REPAGLINIDE
Negative: <3 ng/mL
Note: The report indicates a specific drug is positive if that drug is detected at a concentration greater than the sensitivity limit. The test sensitivity limit listed for each drug is lower than the concentration that will cause increased insulin and decreased glucose.
Cautions
Proper interpretation requires that the blood specimen be drawn during or close to the time of a hypoglycemic episode. Drugs will not be detected (and are not likely to be present) if blood is drawn when blood glucose is normal in nondiabetic patients.
All drugs that stimulate insulin secretion undergo extensive metabolism before excretion. The parent drug is therefore not present in urine. Blood serum is the specimen of choice for detecting use of the hypoglycemic drugs: urine or plasma is not an acceptable specimen.
This test is not intended for therapeutic drug monitoring.
Day(s) Performed
Monday, Wednesday, Friday (9 a.m. cutoff)
Report Available
2 daysPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
80304
G0479 (if appropriate)