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Test Code:
090-31-4002

Order Name:
Insulin Antibodies, Serum **

 
Useful For:
Predicting the future development of type 1 diabetes in asymptomatic children, adolescents, and young adults, when used in conjunction with family history, HLA-typing, and other autoantibodies, including GD65S/81596 Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum and islet cell antigen 2 (IA-2) antibodies

Differential diagnosis of type 1 versus type 2 diabetes

Evaluating diabetics with insulin resistance in patients with established diabetes (type 1 or type 2)

Investigation of hypoglycemia in nondiabetic subjects
 
Methodology:

Radioimmunoassay (RIA)

 
AliasesName:
Anti-Insulin
Human Insulin
INAB (Insulin Antibodies)
Insulin Ab
Insulin Antibody
 
 
 
Test Code:
090-31-4002

Order Name:
Insulin Antibodies, Serum **

 
Patient Preparation:
N/A
 
Collection Specimen Or Container:
Blood/ Plain blood (Red top) 6 mL, 2 tubes
 
Specimen Testing Type:
Serum, minimum volume 1.5 mL x 2 tubes
 
Sub Mission Container:
Plastic tube
 
Rejection Criteria:
Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject
 
Specimen Stabillity:
Specimen Type Temperature Time
Serum Refrigerated, 2oC to 8oC (preferred) 28 days
Serum Frozen 28 days
Serum Ambient  72 hours
 
 
 
Test Code:
090-31-4002

Order Name:
Insulin Antibodies, Serum **

 
Method detail:

Radioimmunoassay (RIA)

 
Schedule:
N/A **Sent out to MAYO, USA
 
Turnaround Time:
Received specimen to reported within 14 days
 
 
Performing Location:
MAYO Laboratory
Referral Lab Services, Laboratory Department 14160-2
 
 
 
Test Code:
090-31-4002

Order Name:
Insulin Antibodies, Serum **

 
 
Clinical Information:

The onset of autoimmune diabetes mellitus (type 1 diabetes mellitus) is preceded (and accompanied) by the appearance of autoantibodies to a variety of pancreatic islet cell antigens in serum, including insulin. The level of these autoantibodies is generally low and may even fall during follow-up. In genetically predisposed, but disease-free, individuals (first degree relatives of patients with type 1 diabetes or individuals with permissive HLA alleles), detection of multiple islet cell autoantibodies is a strong predictor for subsequent development of type I diabetes.

Once type 1 diabetes has become fully manifest, insulin autoantibody levels usually fall to low or undetectable levels. However, after insulin therapy is initiated, autoantibody production may recur as a memory response. Insulin autoantibody production is more common when therapeutic insulin of animal origin is used (rarely used in contemporary practice). Larger therapeutic doses may be required because of antibody-induced insulin resistance.

Insulin antibodies may be found in nondiabetic individuals complaining of hypoglycemic attacks. In this setting their presence can be an indicator of "factitious hypoglycemia" due to the surreptitious injection of insulin, rather than to a clinical problem (eg, insulinoma). However, insulin autoantibodies in nondiabetic subjects can occasionally develop without exposure to exogenous insulin and may rarely become a cause of episodic hypoglycemia. Anti-idiotypic autoantibodies against insulin autoantibodies have been demonstrated in some cases. Interaction of these antibodies with insulin autoantibodies could displace bound insulin from the insulin autoantibodies, resulting in hypoglycemia.

 
Reference Value:

< or =0.02 nmol/L

Reference values apply to all ages.

 
Interpretation:

Seropositivity (> or =0.03 nmol/L) in a patient never treated with insulin is consistent with predisposition to type 1 diabetes. Seropositivity is not as informative of type 2 diabetes status as other islet cell antibodies in patients who are receiving (or have received) insulin therapy because this antibody can arise secondary to therapy. It is thought that high levels of insulin autoantibodies might contribute to insulin resistance.

A family history of type 1 diabetes, other organ-specific autoimmunity and a diabetes-permissive HLA phenotype strengthens the prediction of type 1 diabetes development. The detection of multiple islet cell antibodies is indicative of the likely development of future type 1 diabetes.

In patients presenting with hypoglycemia, the presence of insulin autoantibodies may indicate surreptitious insulin administration or, rarely, insulin autoantibody-related hypoglycemia. The differential diagnosis cannot be made on the basis of insulin autoantibody detection alone. C-peptide and insulin measurements are always required in addition to insulin autoantibody measurements in the diagnosis of hypoglycemia.

 
Clinical Reference:
www.mayocliniclabs.com (Retrieved: 29 Jun 2020)