Pitfalls in Diagnosing Hypoglycemia Due to Exogenous Insulin: Validation and Utility of an Insulin Analog Assay.

ABSTRACT:

Objective

To overcome the limitations of commercially available insulin immunoassays which have variable detection of analog insulin and can lead to clinically discordant results and misdiagnosis in the workup of factitious hypoglycemia.

Patients and methods

We performed analytical validation of a liquid chromatography high resolution accurate mass (LC-HRAM) immunoassay to detect insulin analogs. We completed clinical assessment using a large cohort of human serum samples from 78 unique individuals, and subsequently used the assay in the evaluation of eight individuals with high diagnostic suspicion for factitious hypoglycemia.

Results

The performance characteristics show that the LC-HRAM immunoassay can be applied to detect five commonly used synthetic insulin analog

SUBMITTER: Egan AM 

PROVIDER: S-EPMC9996747 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature