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22792 Insulin Antibodies (INAB)

Insulin Antibodies (INAB)
Test Code: INABSO
Synonyms/Keywords
​Anti-Insulin, Human Insulin, INAB (Insulin Antibodies), Insulin Ab, Insulin Antibody
Useful For
​Predicting the future development of type 1 diabetes in asymptomatic children, adolescents, and young adults, when used in conjunction with family history, HLA-typing, and other autoantibodies, including GD65S/81596 Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum and islet cell antigen 2 (IA-2) antibodies
 
Differential diagnosis of type 1 versus type 2 diabetes
 
Evaluating diabetics with insulin resistance in patients with established diabetes (type 1 or type 2)
 
Investigation of hypoglycemia in nondiabetic subjects
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 mL​ 1.0 mL​ ​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 72 hours​
Frozen ​ ​ ​28 days
Rejection Criteria
Gross hemolysis
​Gross lipemia
​Gross icterus
Interference
​This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Sunday, Wednesday
3 days/negative 5 days/positive​
Radioimmunoassay (RIA)​
Reference Lab
Mayo Clinic Laboratories
Reference Range Information
< or =0.02 nmol/L
References values apply to all ages.
Interpretation
​Seropositivity (> or =0.03 nmol/L) in a patient never treated with insulin is consistent with predisposition to type 1 diabetes. Seropositivity is not as informative of type 2 diabetes status as other islet cell antibodies in patients who are receiving (or have received) insulin therapy because this antibody can arise secondary to therapy. It is thought that high levels of insulin autoantibodies might contribute to insulin resistance.
 
A family history of type 1 diabetes, other organ-specific autoimmunity and a diabetes-permissive HLA phenotype strengthens the prediction of type 1 diabetes development. The detection of multiple islet cell antibodies is indicative of the likely development of future type 1 diabetes.
 
In patients presenting with hypoglycemia, the presence of insulin autoantibodies may indicate surreptitious insulin administration or, rarely, insulin autoantibody-related hypoglycemia. The differential diagnosis cannot be made on the basis of insulin autoantibody detection alone. C-peptide and insulin measurements are always required in addition to insulin autoantibody measurements in the diagnosis of hypoglycemia.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86337​
 ​ ​ ​ ​
Synonyms/Keywords
​Anti-Insulin, Human Insulin, INAB (Insulin Antibodies), Insulin Ab, Insulin Antibody
Ordering Applications
Ordering Application Description
​Centricity ​Insulin Antibodies
​Cerner ​Insulin Antibody
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 mL​ 1.0 mL​ ​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 72 hours​
Frozen ​ ​ ​28 days
Rejection Criteria
Gross hemolysis
​Gross lipemia
​Gross icterus
Interference
​This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
Useful For
​Predicting the future development of type 1 diabetes in asymptomatic children, adolescents, and young adults, when used in conjunction with family history, HLA-typing, and other autoantibodies, including GD65S/81596 Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum and islet cell antigen 2 (IA-2) antibodies
 
Differential diagnosis of type 1 versus type 2 diabetes
 
Evaluating diabetics with insulin resistance in patients with established diabetes (type 1 or type 2)
 
Investigation of hypoglycemia in nondiabetic subjects
Reference Range Information
< or =0.02 nmol/L
References values apply to all ages.
Interpretation
​Seropositivity (> or =0.03 nmol/L) in a patient never treated with insulin is consistent with predisposition to type 1 diabetes. Seropositivity is not as informative of type 2 diabetes status as other islet cell antibodies in patients who are receiving (or have received) insulin therapy because this antibody can arise secondary to therapy. It is thought that high levels of insulin autoantibodies might contribute to insulin resistance.
 
A family history of type 1 diabetes, other organ-specific autoimmunity and a diabetes-permissive HLA phenotype strengthens the prediction of type 1 diabetes development. The detection of multiple islet cell antibodies is indicative of the likely development of future type 1 diabetes.
 
In patients presenting with hypoglycemia, the presence of insulin autoantibodies may indicate surreptitious insulin administration or, rarely, insulin autoantibody-related hypoglycemia. The differential diagnosis cannot be made on the basis of insulin autoantibody detection alone. C-peptide and insulin measurements are always required in addition to insulin autoantibody measurements in the diagnosis of hypoglycemia.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Sunday, Wednesday
3 days/negative 5 days/positive​
Radioimmunoassay (RIA)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86337​
 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.