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TEST ID HYPOG Hypoglycemic Agent Screen, Serum

Reporting Name

Hypoglycemic Agent Screen, S

Specimen Type

Serum Red


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.


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

Method Name

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

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

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

80377

G0480-(if appropriate)

Forms

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

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.

Highlights

If hypoglycemia is the result of an insulin-stimulating drug, this test will detect the drug at physiologically significant concentrations during an episode of hypoglycemia.