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Case Reports
. 2022 Jul 12:31:e00291.
doi: 10.1016/j.plabm.2022.e00291. eCollection 2022 Aug.

Explaining unexplained hypoglycemia: How LC-MS/MS can help

M T Ackermans  1 , J Hopman  2 , A C Heijboer  1   3 , S E Siegelaar  4
Affiliations
Case Reports

Explaining unexplained hypoglycemia: How LC-MS/MS can help

M T Ackermans et al. Pract Lab Med. .

Abstract

Explaining hypoglycaemia, especially in patients without diabetes mellitus, is challenging. Here we present a case, where the added value for clinical diagnosis of insulin determination with liquid chromatography-mass spectrometry (LC-MS/MS) is shown. By the use of LC-MS/MS the different insulin analogues can be identified. The confirmation of an insulin analogue present during hypoglycaemia facilitated in our case the discussion with the patient and his family about what happened.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
LS-MS/MS chromatograms of (A) the case patient sample and (B) positive control. The panels show the chromatograms for the different insulins. The insulins can be identified based upon their retention time and specific MRM transition.
See this image and copyright information in PMC

References

    1. Cryer P.E., et al. Evaluation and management of adult hypoglycemic disorders: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2009;94(3):709–728. - PubMed
    1. Mathieu C., Gillard P., Benhalima K. Insulin analogues in type 1 diabetes mellitus: getting better all the time. Nat. Rev. Endocrinol. 2017;13(7):385–399. - PubMed
    1. Parfitt C., et al. Commercial insulin immunoassays fail to detect commonly prescribed insulin analogues. Clin. Biochem. 2015;48(18):1354–1357. - PubMed
    1. Heald A.H., et al. Most commercial insulin assays fail to detect recombinant insulin analogues. Ann. Clin. Biochem. 2006;43:306–308. - PubMed
    1. Heurtault B., et al. Extensive study of human insulin immunoassays: promises and pitfalls for insulin analogue detection and quantification. Clin. Chem. Lab. Med. 2014;52(3):355–362. - PubMed

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