Symptoms, signs, or both | Glucose (mg/dL)/(mmol/L) | Insulin (microU/mL)/(pmol/L) | C-peptide (nmol/L)/(ng/mL) | Proinsulin (pmol/L) | Beta-hydroxybutyrate (mmol/L) | Glucose increase after glucagon (mg/dL)/(mmol/L) | Circulating oral hypoglycemic agent | Antibody to insulin | Diagnostic interpretation |
No | <55/3 | <3/20.8 | <0.2/0.6 | <5 | >2.7 | <25/1.4 | No | No | Normal |
Yes | <55 | >>3 | <0.2 | <5 | ≤2.7 | >25 | No | Neg (Pos) | Exogenous insulin |
Yes | <55 | ≥3 | ≥0.2 | ≥5 | ≤2.7 | >25 | No | Neg | Insulinoma, NIPHS, PGBH |
Yes | <55 | ≥3 | ≥0.2 | ≥5 | ≤2.7 | >25 | Yes | Neg | Oral hypoglycemic agent |
Yes | <55 | >>3 | >>0.2¶ | >>5¶ | ≤2.7 | >25 | No | Pos | Insulin autoimmune |
Yes | <55 | <3 | <0.2 | <5 | ≤2.7 | >25 | No | Neg | IGFΔ |
Yes | <55 | <3 | <0.2 | <5 | >2.7 | <25 | No | Neg | Not insulin (or IGF)-mediated |
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