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HelpTest Code INAB Insulin Antibodies, Serum
Reporting Name
Insulin Abs, SUseful For
Predicting the future development of type 1 diabetes in asymptomatic children, adolescents, and young adults, when used in conjunction with family history, human leukocyte antigen-typing, and other autoantibodies, including glutamic acid decarboxylase (GAD65) 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
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reference Values
≤0.02 nmol/L
Reference values apply to all ages.
Day(s) Performed
Sunday, Wednesday
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
86337
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| INAB | Insulin Abs, S | 60463-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8666 | Insulin Abs, S | 60463-7 |
Interpretation
Seropositivity (≥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 human leukocyte antigen 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.
Clinical Reference
1. Schernthaner G. Immunogenicity and allergenic potential of animal and human insulins. Diabetes Care. 1993;16 Suppl3:155-165
2. Lernmark A. Type 1 diabetes. Clin Chem. 1999;45(8 Pt 2):1331-1338
3. Eisenbarth GS, Jeffery J. The natural history of type 1A diabetes. Arq Bras Endocrinol Metabol. 2008;52(2):146-155
4. Thomas NJ, Jones AG. The challenges of identifying and studying type 1 diabetes in adults [published online ahead of print, 2023 Sep 20]. Diabetologia. 2023;10.1007/s00125-023-06004-4. doi:10.1007/s00125-023-06004-4
Report Available
3 to 9 daysMethod Name
Radioimmunoassay (RIA)