Related Experiment Video
Updated: Jun 15, 2025

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT
Published on: January 7, 2018
A Case of False Insulin Test Results Due to the Megaloblastic Anemia
Background:
Megaloblastic anemia is a subtype of anemia with increased red blood cell volume. These megaloblastic cells can be easily destroyed in the bone marrow and spleen, leading to ineffective hematopoiesis. Insulin-degrading enzymes (IDE) in erythrocytes can break down the insulin into amino acid fragments; thus, when hemolysis occurs, IDE can be released into the blood, resulting in low insulin measurement values.
Methods:
This article reports a case of false insulin test results due to the hemolysis resulting from megaloblastic anemia.
Results:
The patient's first fasting glucose results indicated that the glucose and C-peptide levels were within the normal range while her insulin level was abnormally low. After hemolysis was corrected, the relevant indicators were re-evaluated and all the results were normal.
Conclusions:
This article reports a patient diagnosed with megaloblastic anemia, whose dysmorphic erythrocytes cause severe extravascular hemolysis. It was the occurrence of hemolysis that the IDE released into the blood, leading to the abnormal insulin test result.
Related Concept Videos
Hypoglycemia and Glucagon
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Diabetes Mellitus: Type 2 and Gestational
Diabetes: Symptoms, Diagnosis, and Complications
Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...

