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Test Code HYPOG Hypoglycemic Agent Screen, Serum


Specimen Required


Patient Preparation: Specimen must be collected during an episode of hypoglycemia.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume:1.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Evaluation of suspected insulinoma characterized by hypoglycemia and increased serum insulin concentration

 

Detecting drugs that stimulate insulin secretion

 

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.

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Hypoglycemic Agent Screen, S

Specimen Type

Serum Red

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Frozen (preferred) 28 days
  Refrigerated  28 days
  Ambient  7 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

Negative

Screening cutoff concentrations

Chlorpropamide: 100 ng/mL

Glimepiride: 20 ng/mL

Glipizide: 5 ng/mL

Glyburide: 5 ng/mL

Nateglinide: 5 ng/mL

Pioglitazone: 20 ng/mL

Repaglinide: 5 ng/mL

Rosiglitazone: 20 ng/mL

Tolazamide: 50 ng/mL

Tolbutamide: 20 ng/mL

 

Note: If a drug is detected at a concentration greater than the cutoff, the report will indicate that specific drug is positive. The test cutoff listed for each drug is lower than the concentration that will cause increased insulin and decreased glucose.

Day(s) Performed

Monday, Wednesday, Friday

Report Available

2 to 6 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80377

G0480-(if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HYPOG Hypoglycemic Agent Screen, S 68318-5

 

Result ID Test Result Name Result LOINC Value
21295 Chlorpropamide 48329-7
21298 Glimepiride 48325-5
21299 Glipizide 48326-3
21300 Glyburide 48327-1
609767 Nateglinide 49487-2
609768 Pioglitazone 100351-6
21301 Repaglinide 48328-9
609769 Rosiglitazone 100352-4
21296 Tolazamide 21566-5
21297 Tolbutamide 21567-3

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.