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

CPE-002 · synthetic case CPE002-EX-05

Medication list unavailable

Fasting glucose 108 mg/dL and no medication history on file.

Synthetic · no real patientExtended demonstration caseMetabolic engine v1.0.0

Purpose: Fasting glucose 108 mg/dL and no medication history on file.

Inputs the engine received

Patient

Age
57 years

Context

Sex for threshold application
male
Fasting confirmed
Yes

Laboratory

Fasting plasma glucose
108 mg/dL

What the engine reports

Detected clinical pattern

Prediabetes Criteria Met

At least one guideline prediabetes criterion is met.

  • Glycemic: Prediabetes Criteria Met
  • Validity: Interpretation valid
  • Metabolic syndrome: Metabolic syndrome: incomplete assessment
  • IR-associated pattern: IR-associated pattern: not assessable

Why this pattern was identified

  • Glycemic criteria met. FPG 100–125 mg/dL.

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Review prediabetes criteria and the patient's risk profile per current standards of care.Guideline criterion met (ADA).

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).
  • Fasting insulin (supporting pattern only; fasting and same-collection glucose required).
  • Active medication list (medication effects on glucose, insulin or lipids cannot be excluded).
Evidence and rule trace · 9 rules

GLY-002Prediabetes by FPG

Inputs: FPG 108 mg/dL · fasting confirmed

PREDIABETES_FPG_CRITERION_MET

METS-COMP-005Fasting glucose ≥100 mg/dL (or treated)

Inputs: fasting glucose 108 mg/dL

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

MISS-001Insulin Pattern Missing Data

Inputs: fasting insulin not provided

IR_PATTERN_NOT_FULLY_ASSESSABLE_WITH_CURRENT_DATA

MISS-003Medication Context Missing

Inputs: medication list not available

MEDICATION_CONTEXT_NOT_AVAILABLE

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.

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
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

Prediabetes Criteria Met

At least one guideline prediabetes criterion is met.

  • Glycemic: Prediabetes Criteria Met
  • Validity: Interpretation valid
  • Metabolic syndrome: Metabolic syndrome: incomplete assessment
  • IR-associated pattern: IR-associated pattern: not assessable

Why this pattern was identified

  • Glycemic criteria met. FPG 100–125 mg/dL.

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Review prediabetes criteria and the patient's risk profile per current standards of care.Guideline criterion met (ADA).

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).
  • Fasting insulin (supporting pattern only; fasting and same-collection glucose required).
  • Active medication list (medication effects on glucose, insulin or lipids cannot be excluded).
Evidence and rule trace · 9 rules

GLY-002Prediabetes by FPG

Inputs: FPG 108 mg/dL · fasting confirmed

PREDIABETES_FPG_CRITERION_MET

METS-COMP-005Fasting glucose ≥100 mg/dL (or treated)

Inputs: fasting glucose 108 mg/dL

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

MISS-001Insulin Pattern Missing Data

Inputs: fasting insulin not provided

IR_PATTERN_NOT_FULLY_ASSESSABLE_WITH_CURRENT_DATA

MISS-003Medication Context Missing

Inputs: medication list not available

MEDICATION_CONTEXT_NOT_AVAILABLE

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.

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.

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