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CPE-002 · Insulin-resistance–associated pattern
IRP-002: Hyperinsulinemic Supporting Pattern
Hyperinsulinemic Supporting Pattern. Fires when fasting_insulin above validated_institutional_or_assay_specific_threshold.
This is a research rule. It stays off in production until an assay-specific threshold profile and external specialist validation exist. In the metabolic playground you can enable the sandbox with your own thresholds.
Condition
- fasting_insulin > validated_institutional_or_assay_specific_threshold
Required before it can be enabled
- Assay specific threshold profile
- External endocrinology validation
- Fasting confirmed
- No insulin or secretagogue interference
Output
- HYPERINSULINEMIC_SUPPORTING_PATTERN_IDENTIFIED
Diagnostic boundary
- Does not independently establish insulin resistance.
Evidence
- EV-NIDDK-IRNational Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance & Prediabetes.Supports: Insulin resistance testing is not routine diagnostic testing in the same way as prediabetes testing. Prediabetes testing uses A1C, fasting plasma glucose, or OGTT.
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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.
CPE002-FX-007
Hyperinsulinemic Pattern with Normal Glycemic Tests
Normal glucose and HbA1c, fasting insulin 22 µIU/mL, TG 170, HDL 42.
CPE002-FX-008
Acanthosis with Insufficient Lab Data
Acanthosis nigricans on exam. No labs yet.
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