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CPE-002 · synthetic case CPE002-FX-014
Hypoglycemia with Inappropriate Insulin
A low-glucose event with inappropriately high insulin.
Purpose: Hypoglycemia pathway, not a metabolic-pattern interpretation.
Inputs the engine received
Patient
- Age
- 61 years
Context
- Sex for threshold application
- male
- Active medication list available
- Yes
- Event glucose low
- Yes
- Inappropriate insulin during event
- Yes
- Fasting confirmed
- Yes
Laboratory
- Fasting insulin
- 38 µIU/mL
What the engine reports
Low glucose with inappropriate insulin during the event requires the hypoglycemia pathway, not a metabolic-pattern interpretation. Insulin-resistance pattern rules are suppressed.
Detected clinical pattern
Urgent Review Finding
A safety rule requires urgent physician review. See the priority safety findings first; pattern rules that could mislead were suppressed.
- Glycemic: Glycemic Category Not Assessable
- Validity: Interpretation valid
- Metabolic syndrome: Metabolic syndrome: incomplete assessment
- IR-associated pattern: IR-associated pattern: not assessable
- Safety: Urgent review
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Urgent physician review under the hyperinsulinemic-hypoglycemia pathway.
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
SAFE-HYPO-001Hypoglycemia with Inappropriate Insulin Concern
Inputs: low glucose during event · inappropriate insulin during event
HYPERINSULINEMIC_HYPOGLYCEMIA_PATHWAY_REVIEW
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.
IRP_PATTERN_RULESirp pattern rulessuppressed
Suppressed by a validity or safety rule.
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
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.
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