Hypoglycemic Agent Screen

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: chlorpropamide (Diabinese), tolazamide, and tolbutamide (Orinase)
  • The second-generation sulfonylureas: glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (Glibenclamide)
  • The meglitinides: repaglinide (Prandin) and nateglinide (Starlix)
  • The thiazolidinediones: pioglitazone (Actos) and rosiglitazone (Avandia)This test is not intended for therapeutic drug monitoring but could be used to monitor compliance.

Note: The report indicates a specific drug is positive if that drug is detected at a concentration greater than the cutoff. The test cutoff 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 screen does not include the first-generation sulfonylurea acetohexamide.

Other drugs designed to make tissues more sensitive to insulin that do not induce hypoglycemia, thiazolidinediones such as troglitazone and lobeglitazone, 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.

9 mL blood in RED TOP tube

Unacceptable: any other tube type.

Outside Laboratories: Centrifuge specimen and transfer serum to a separate plastic vial. Freeze serum at -20°C.

Stability: Frozen (preferred): 28 days; Refrigerated: 28 days; Ambient 7 days.

Reject Due To: Gross lipemia, gross icterus, gross hemolysis are okay.

Centrifuge specimen and transfer serum to a separate plastic vial. Freeze serum at -20°C.

Login: SEND1-;FREEZE

• RSNDT1: MAYO
• RSTYP1: SERUM
• RTSRQ1: ;Hypoglycemic Agent Screen (Mayo test HYPOG)

Sendouts: order Mayo Test: HYPOG.

Stability: Frozen (preferred): 28 days; Refrigerated: 28 days; Ambient 7 days.

Reject Due To: Gross lipemia, gross icterus, gross hemolysis are okay.