Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.

CPE-002 · synthetic case CPE002-EX-01

Fasting insulin drawn without confirmed fasting

A fasting insulin of 18 µIU/mL and glucose 105 mg/dL, but the patient was not fasting.

Synthetic · no real patientExtended demonstration caseMetabolic engine v1.0.0

Purpose: A fasting insulin of 18 µIU/mL and glucose 105 mg/dL, but the patient was not fasting.

Inputs the engine received

Patient

Age
50 years

Context

Sex for threshold application
female
Active medication list available
Yes

Laboratory

Fasting plasma glucose
105 mg/dL
Fasting insulin
18 µIU/mL

What the engine reports

Detected clinical pattern

Glycemic Category Not Assessable

No interpretable glycemic test was entered, so a glycemic category cannot be assigned.

  • Glycemic: Glycemic Category Not Assessable
  • Validity: Interpretation limited
  • Metabolic syndrome: Metabolic syndrome: incomplete assessment
  • IR-associated pattern: IR-associated pattern: not assessable

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Interpret with the listed validity modifiers in mind.fasting status not confirmed

Missing information

  • An interpretable glycemic test (confirmed-fasting glucose, HbA1c without interference, or a protocol-confirmed 2-h OGTT).
  • Metabolic syndrome components not entered: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated).
Evidence and rule trace · 6 rules

VALIDITY-002Fasting Required for Insulin Pattern

Inputs: fasting insulin 18 µIU/mL · fasting not confirmed

FASTING_STATUS_NOT_CONFIRMED

MISS-002Metabolic Syndrome Incomplete Data

Inputs: 0 of 5 components met · missing: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated)

METABOLIC_SYNDROME_ASSESSMENT_INCOMPLETE

IRP-002Hyperinsulinemic Supporting Patternsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

IRP-003Elevated HOMA-IR Supporting Findingsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

IRP-004Convergent IR-Associated Patternsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

TREND-MET-001Composite Metabolic Deterioration Warningsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

HOMA_IR_INTERPRETATIONhoma ir interpretationsuppressed

Suppressed by a validity or safety rule.

IRP_PATTERN_RULESirp pattern rulessuppressed

Suppressed by a validity or safety rule.

Evidence

  • EV-NIDDK-IR · National Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance & Prediabetes.

Physician adjudication required. Clinical decision support only. This output identifies guideline-based glycemic and metabolic findings and risk context. It does not diagnose insulin resistance, select treatment or recommend medication. Physician adjudication is required.

Change the values

The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.

Glycemic testsDrag the sliders to cross a threshold
  • <100
  • 100–125 prediabetes
  • ≥126 diabetes range
  • <5.7
  • 5.7–6.4 prediabetes
  • ≥6.5 diabetes range

75-g protocol

Lipids, body and blood pressure
  • <150
  • 150–499
  • ≥500 priority
  • ≥1000 urgent

Metabolic syndrome components0 of 5

  • ○ Waist not entered
  • ○ Triglycerides not entered
  • ○ Low HDL-C not entered
  • ○ Blood pressure not entered
  • ○ Fasting glucose not entered

● met · ◌ not met · ○ not entered. Three or more meet the criteria; that does not confirm insulin resistance.

Patient and scope
Sex for thresholds
Ketones
Symptoms and safety
Risk context
Liver context
Medications
Outside the standard adult runtime
Fasting insulin (supporting only)Calculation and sandbox

Shown with HOMA-IR when fasting and same-collection are confirmed. It does not classify anything.

Research sandbox (unvalidated)

In production the insulin and HOMA-IR rules are off: no validated threshold profile exists. Here you can supply your own threshold to see how the sandbox rules would behave. The output is labeled a sandbox candidate and is never a diagnosis.

Live result · computed in your browser

Detected clinical pattern

Glycemic Category Not Assessable

No interpretable glycemic test was entered, so a glycemic category cannot be assigned.

  • Glycemic: Glycemic Category Not Assessable
  • Validity: Interpretation limited
  • Metabolic syndrome: Metabolic syndrome: incomplete assessment
  • IR-associated pattern: IR-associated pattern: not assessable

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Interpret with the listed validity modifiers in mind.fasting status not confirmed

Missing information

  • An interpretable glycemic test (confirmed-fasting glucose, HbA1c without interference, or a protocol-confirmed 2-h OGTT).
  • Metabolic syndrome components not entered: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated).
Evidence and rule trace · 6 rules

VALIDITY-002Fasting Required for Insulin Pattern

Inputs: fasting insulin 18 µIU/mL · fasting not confirmed

FASTING_STATUS_NOT_CONFIRMED

MISS-002Metabolic Syndrome Incomplete Data

Inputs: 0 of 5 components met · missing: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated)

METABOLIC_SYNDROME_ASSESSMENT_INCOMPLETE

IRP-002Hyperinsulinemic Supporting Patternsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

IRP-003Elevated HOMA-IR Supporting Findingsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

IRP-004Convergent IR-Associated Patternsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

TREND-MET-001Composite Metabolic Deterioration Warningsandbox · off

Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.

HOMA_IR_INTERPRETATIONhoma ir interpretationsuppressed

Suppressed by a validity or safety rule.

IRP_PATTERN_RULESirp pattern rulessuppressed

Suppressed by a validity or safety rule.

Evidence

  • EV-NIDDK-IR · National Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance & Prediabetes.

Physician adjudication required. Clinical decision support only. This output identifies guideline-based glycemic and metabolic findings and risk context. It does not diagnose insulin resistance, select treatment or recommend medication. Physician adjudication is required.

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