Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.For licensed clinicians. Educational demonstration on synthetic data. Never enter real patient identifiers or protected health information: everything runs in your browser and nothing is sent or stored. Clinical decision support only; not FDA cleared; physician review is required.
CPE-002 · synthetic case CPE002-EX-02
Patient on insulin therapy with a high insulin level
Insulin 30 µIU/mL in a patient who injects insulin, with fasting glucose 150 mg/dL.
Purpose: Insulin 30 µIU/mL in a patient who injects insulin, with fasting glucose 150 mg/dL.
Inputs the engine received
Patient
- Age
- 62 years
Context
- Sex for threshold application
- male
- Active medication list available
- Yes
- Fasting confirmed
- Yes
- Insulin therapy active
- Yes
- Glucose lowering medication active
- Yes
Laboratory
- Fasting plasma glucose
- 150 mg/dL
- Fasting insulin
- 30 µIU/mL
What the engine reports
A guideline diabetes-range criterion is met. Physician review and confirmation per standards of care are required.
Detected clinical pattern
Diabetes-Range Finding — Physician Review
At least one guideline diabetes-range criterion is met; physician review and confirmation are required.
- Glycemic: Diabetes-Range Finding — Physician Review
- Validity: Interpretation limited
- Metabolic syndrome: Metabolic syndrome: incomplete assessment
- IR-associated pattern: IR-associated pattern: not assessable
- Safety: Priority review
Why this pattern was identified
- Glycemic criteria met. FPG in diabetes range.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Confirm the diabetes-range finding per standards of care and review diabetes type.Diabetes-range criterion met.
- 2Interpret with the listed validity modifiers in mind.treated metabolic state present; insulin measurement not interpretable for baseline pattern
Differentials, pitfalls and contradicting signals
- Diabetes type (type 2, type 1/LADA, monogenic, secondary) is a physician determination.
- Treated metabolic state: glucose, insulin and lipid values may be modified by therapy.
Missing information
- 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).
Evidence and rule trace · 9 rules
VALIDITY-003Treated Metabolic State
Inputs: glucose-lowering medication
TREATED_METABOLIC_STATE_PRESENT
VALIDITY-004Exogenous Insulin or Secretagogue Suppression
Inputs: insulin therapy
INSULIN_MEASUREMENT_NOT_INTERPRETABLE_FOR_BASELINE_PATTERN
SAFE-GLY-001Diabetes-Range Laboratory Finding
Inputs: FPG 150 mg/dL
DIABETES_RANGE_FINDING_REQUIRES_PHYSICIAN_REVIEW
METS-COMP-005Fasting glucose ≥100 mg/dL (or treated)
Inputs: on glucose-lowering medication
METS_GLUCOSE_COMPONENT_MET
MISS-002Metabolic Syndrome Incomplete Data
Inputs: 1 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)
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.
FASTING_INSULIN_PATTERN_CLASSIFICATIONfasting insulin pattern classificationsuppressed
Suppressed by a validity or safety rule.
HOMA_IR_PATTERN_CLASSIFICATIONhoma ir pattern classificationsuppressed
Suppressed by a validity or safety rule.
Evidence
- EV-ADA-2026-DIAG · American Diabetes Association Professional Practice Committee for Diabetes. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27-S49.
- EV-METS-2009 · IDF/AHA/NHLBI/WHF/IAS/IASO Joint Interim Statement. Harmonizing the Metabolic Syndrome. Circulation. 2009;120:1640-1645.
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 components1 of 5
- ○ Waist not entered
- ○ Triglycerides not entered
- ○ Low HDL-C not entered
- ○ Blood pressure not entered
- ● Fasting glucose met
● met · ◌ not met · ○ not entered. Three or more meet the criteria; that does not confirm insulin resistance.
Patient and scope
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.
More metabolic cases
CPE002-FX-001
Healthy Metabolic Baseline
A 35-year-old with normal glucose, lipids, waist and blood pressure.
CPE002-FX-002
Prediabetes by HbA1c
HbA1c of 6.0% and nothing else.
CPE002-FX-003
Prediabetes by FPG
Confirmed-fasting glucose of 108 mg/dL.
CPE002-FX-004
OGTT-Only Prediabetes
Only a 75-g OGTT: 2-hour glucose 165 mg/dL.
CPE002-FX-005
Diabetes-Range Finding
HbA1c 6.8% and fasting glucose 134 mg/dL.
CPE002-FX-006
Metabolic Syndrome with Normal Glucose
Normal glucose, but waist 108 cm, TG 190, HDL 36 and BP 138/88.
Try Biod in your practice
The Clinical Intelligence Layer — transforming fragmented clinical information into structured intelligence for clinician review and action.