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Test Code:
INSULR

Order Name:
Insulin

 
Useful For:
Determination of human insulin in human serum.
 
Methodology:
Chemiluminescent Microparticle Immuno Assay (CMIA)
 
 
 
Test Code:
INSULR

Order Name:
Insulin

 
Patient Preparation:
Fasting 8 hours
 
Collection Specimen Or Container:
Blood/ Plain Blood (Red Top) 6 mL, 1 tube
 
Specimen Testing Type:
Serum, minimum volume 1 mL
 
Sub Mission Container:
Plastic vial
 
Rejection Criteria:
Hemolysis: 4+ reject
 
Specimen Stabillity:
Specimen Type Temperature Time
Serum (keep in original tube) Refrigerated, 2oC to 8oC 8 hours
Serum Frozen, -10oC 7 days
 
 
 
Test Code:
INSULR

Order Name:
Insulin

 
Method detail:
Chemiluminescent Microparticle Immuno Assay (CMIA)
 
Schedule:
Tested Daily (24 Hours)
 
 
Turnaround Time:
Specimen collected to reported within 2:00 hours (120 mins)
 
Performing Location:
Immunology, Laboratory Department Tel. 13227
 
Specimen Retention Time:
5 days
 
 
 
Test Code:
INSULR

Order Name:
Insulin

 
 
Clinical Information:
Insulin is a polypeptide hormone (MW 6000) composed of two nonidentical chains, A and B, which are joined by two disulfide bonds. Insulin is formed from a precursor, proinsulin (MW 9000), in the beta cells of the pancreas. In proinsulin, the A and B chains are joined by a connecting peptide, referred to as the C-peptide. Both insulin and C-peptide are stored in secretory granules of the islet cells of the pancreas and are then secreted. Insulin secretion follows two basic mechanisms, tonic secretion and biphasic secretion. The basal or tonic secretion is independent of stimulation by exogenous glucose but is modulated by the fluctuations in physiological levels of glucose. The biphasic secretion is primarily a direct response from stimulation by exogenous glucose. Stimulation of insulin secretion can be caused by many factors including hyperglycemia, glucagon, amino acids, and by complex mechanisms involving growth hormone or catecholamines.

Increased levels of Insulin are found with obesity, Cushing’s Syndrome, oral contraceptives, acromegaly, insulinoma and hyperthyroidism. Decreased levels of insulin are found in overt diabetes mellitus (although this may not be clearly expressed in early stages of the condition) and by part of a complex mechanism involving catecholamines. “Immunoreactive insulin” (IRI) is a term often used to refer to the component of circulating insulin and insulin-like biological activity which can be measured using antibodies against insulin. Insulinomas may produce various forms of insulin and proinsulin-like material and show total immunoreactive insulin at
normal or elevated levels. Since proinsulin and insulin both contain A and B polypeptide chains, there is a possible cross-reactivity with antibodies generated against insulin. The ARCHITECT Insulin assay shows no cross-reactivity with proinsulin (≤ 0.1% at 106 pg/mL). Another possible interference is brought about by insulin antibodies which develop in patients treated with bovine or porcine insulin.

Immunoassays for insulin have been widely used to provide supplementary information, first, for the diagnosis of diabetes mellitus and, second, for differential diagnosis of fasting hypoglycemia to discriminate between insulinoma and factitious hypoglycemia. In these applications, the ratio of immunoreactive insulin to blood glucose (I/G) may be more valuable than the insulin level alone. Furthermore, a single random blood sample may provide insufficient information due to wide variations in the time responses of insulin levels and blood glucose which are found among individuals and various clinical conditions. Other uses of insulin assays have been suggested by the finding of an increase in risk factors for coronary artery disease among healthy persons with hyperinsulinemia and normal glucose tolerance.
 
Reference Value:
2.5 - 15 µU/mL
 
Clinical Reference:
  1. Manufacturer’s Reagent package insert Architect Insulin, September 2015, Abbott Laboratories, Diagnostic Division, Abbott Park IL 60064 USA.
  2. Patient Preparation: https://www.mayocliniclabs.com (Retrieved: Jan 2019)
  3. Reference intervals (normal values) : Bumrungrad hospital Method Validation/Verification Reference Range Establishment for Architect System (Year 2014)