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Laboratory evidence for hyperinsulinism

Laboratory evidence for hyperinsulinism
When plasma glucose <50 mg/dL
Laboratory test: Threshold for abnormal in this setting
Low betahydroxybutyrate <1.8 mmol/L
Low free fatty acids <1.7 mmol/L
Detectable insulin* >2 microU/mL
Detectable C-peptide* >0.5 ng/mL
Glycemic response to glucagon ≥30 mg/dL increase in plasma glucose after glucagon administration
* When plasma glucose is <50 mg/dL (2.8 mmol/L), any detectable amount of insulin or C-peptide is abnormal and supports the diagnosis of hyperinsulinism. However, an undetectable insulin level does not rule out hyperinsulinism, given the limitations and variable sensitivity of insulin assays.
Graphic 128060 Version 2.0

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