During prolonged fasting, when the patient's glucose is reduced to <40.0 mg/dL, elevated insulin level plus elevated levels of proinsulin and C-peptide suggest insulinoma.
In patients with insulin-dependent diabetes mellitus, insulin levels generally decline.
In the early stage of noninsulin dependent diabetes mellitus (NIDDM), insulin levels are either normal or elevated.
In the late stage of NIDDM, insulin levels may also decline as levels of proinsulin decrease.