To help evaluate insulin production by the beta cells in the pancreas; to help diagnose the presence of an insulin-producing tumor in the islet cells of the pancreas (insulinoma); to help determine the cause of low blood glucose (hypoglycemia); to help identify insulin resistance, or to help determine when a type 2 diabetic might need to start taking insulin to supplement oral medications
Insulin
Insulin
Also Known As
Fasting Insulin
Formal Name
Insulin, serum
This article was last reviewed
on
This article waslast modified
on
May 26, 2018.
At a Glance
Why Get Tested?
When To Get Tested?
When you have low blood glucose levels with symptoms such as sweating, palpitations, dizziness, fainting; when you have diabetes and your health practitioner wants to monitor your insulin production; sometimes when it is suspected that you have insulin resistance
Sample Required?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
You may be asked to fast for 8 hours before the blood sample is collected, but occasionally a health practitioner may do the test with, for example, a glucose tolerance test. In some cases, a health practitioner may request that you fast longer.
Accordion Title
Common Questions
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How is it used?
Insulin testing has several possible uses. Insulin is a hormone that is produced and stored in the beta cells of the pancreas. Insulin helps transport glucose , the body's main source of energy, from the blood to within cells. If a person makes too little insulin or is resistant to its effects, cells starve. If someone makes too much, as may happen with an insulin-producing tumor (insulinoma) for example, then symptoms of low blood glucose (hypoglycemia) emerge.
Insulin testing may be used to help:
- Diagnose an insulinoma, verify that removal of the tumor has been successful, and/or to monitor for recurrence
- Diagnose the cause of hypoglycemia in an individual with signs and symptoms
- Identify insulin resistance
- Monitor the amount of insulin produced by the beta cells in the pancreas (endogenous); in this case, a C-peptide test may also be done. Insulin and C-peptide are produced by the body at the same rate as part of the conversion of proinsulin to insulin in the pancreas. Both tests may be ordered when a health practitioner wants to evaluate how much insulin in the blood is made by the body and how much is from outside (exogenous) sources such as insulin injections. The test for insulin measures insulin from both sources while the C-peptide test reflects insulin produced by the pancreas.
- Determine when a type 2 diabetic might need to start taking insulin to supplement oral medications
- Determine and monitor the success of an islet cell transplant intended to restore the ability to make insulin, by measuring the insulin-producing capacity of the transplant
Insulin testing may be ordered with glucose and C-peptide tests. Insulin levels are also sometimes used in conjunction with the glucose tolerance test (GTT). In this situation, blood glucose and insulin levels are measured at pre-established time intervals to evaluate insulin resistance.
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When is it ordered?
Insulin levels are most frequently ordered following a low glucose and/or when someone has acute or chronic symptoms of low blood glucose (hypoglycemia) caused by, for example, an insulinoma. Symptoms of hypoglycemia may include:
- Sweating
- Palpitations
- Hunger
- Confusion
- Blurred vision
- Dizziness
- Fainting
- In serious cases, seizures and loss of consciousness
These symptoms may indicate low blood glucose but may also be seen with other conditions.
An insulin test may also be done when an individual has or is suspected of having insulin resistance. This may include people with type 2 diabetes, polycystic ovarian syndrome (PCOS), prediabetes or heart disease, or metabolic syndrome.
A health practitioner also may order insulin and C-peptide tests after an insulinoma has been successfully removed to verify the effectiveness of treatment and then order the tests periodically to monitor for recurrence.
Periodic testing may also be used to monitor the success of an islet cell transplant by measuring the insulin-producing capacity of the transplant.
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What does the test result mean?
Insulin levels must be evaluated in context.
Results seen:
Disorder fasting insulin level fasting glucose level None Normal Normal Insulin resistance High Normal or somewhat elevated Not enough insulin produced by the beta cells (as seen in diabetes, pancreatitis, for example) Low High Hypoglycemia due to excess insulin (may be seen in insulinomas, Cushing syndrome, excess administration of exogenous insulin, etc.) Normal or high Low Elevated insulin levels are seen with:
- Acromegaly
- Cushing syndrome
- Use of drugs such as corticosteroids, levodopa, oral contraceptives
- Fructose or galactose intolerance
- Insulinomas
- Obesity
- Insulin resistance, such as appears in type 2 diabetes and metabolic syndrome
Decreased insulin levels are seen with:
- Diabetes
- Hypopituitarism
- Pancreatic diseases such as chronic pancreatitis (including cystic fibrosis) and pancreatic cancer
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Is there anything else I should know?
Insulin for injection used to come strictly from animal sources (cow and pig pancreas cells). Most insulin used today is synthetic, made by biochemical synthesis to identically match the biological activity of the insulin produced by human cells.
There are different pharmaceutical formulations of insulin with different properties. Some are rapid-release and quick-acting and others are slow-release preparations that act over a prolonged period. Diabetics may take mixtures and/or different types of insulin throughout the day.
Insulin assays are designed to measure endogenous human insulin. However, different assays react variably with exogenous (animal or synthetic) insulin. If someone is receiving insulin, these effects should be clarified with the testing laboratory. If several or periodic insulin assays will be performed, they should be analyzed by the same laboratory to ensure consistency.
The insulin tolerance test (ITT) is not widely used, but is one method for determining insulin sensitivity (or resistance), especially in obese individuals and those with PCOS. This test involves an IV-infusion of insulin, with subsequent measurements of glucose and insulin levels.
If someone has developed antibodies against insulin, especially as a result of taking non-human (animal or synthetic) insulin, these can interfere with insulin testing. In this case, a C-peptide may be performed as an alternative way to evaluate insulin production. Note also that most people with type 1 diabetes will also have autoantibodies against insulin.
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Can I do an insulin test at home?
No. Although glucose levels can be monitored at home, insulin tests require specialized instruments and training are are perforemd at laboratories.
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Why does insulin have to be injected?Insulin must be injected or given via an insulin pump. It cannot be given orally because it is a protein and is broken down in the stomach before it can be absorbed.
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How is an insulinoma treated?Insulinomas are insulin-producing tumors that are usually benign. They are typically treated by being located and removed. Once removed, generally they do not return.
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What else is important about insulin resistance?
Insulin resistance is a warning signal that the body is having problems processing glucose and it is characteristic of prediabetes. People with early or moderate insulin resistance often don't have any symptoms, but if their condition is ignored, it puts them at a much greater risk of developing type 2 diabetes, hypertension, hyperlipidemia, and/or heart disease several years down the road. Abdominal obesity, insulin resistance, dyslipidemia, and hypertension form a set of risk factors that are referred to as metabolic syndrome.
Risk factors for insulin resistance include:
- Obesity, especially abdominal obesity
- Family history of diabetes or insulin resistance
- Gestational diabetes
- Polycystic ovary syndrome
Treatment of insulin resistance involves changes in diet and lifestyle. The American Diabetes Association recommends losing excess weight, getting regular amounts of moderate intensity physical activity, and increasing dietary fiber to lower blood insulin levels and increase the body's sensitivity to it.
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