Does anyone know of a good Perl unit test generator?

What insulin-unit did they use, and was it hypoglycemia?

• I am participating in a research project about hormone levels, where my data will be used to reference when comparing it to patients who have a less-than-working hypophysis. To do this, they gave me insulin: As a non-diabetic, this would lower my blood sugar levels, and my body would 'fight back' with all the hormones, and then the doctors could measure these hormones etc. Just out of curiosity, I have a few questions (due to the low blood-sugar levels I had during the test, I did not think to ask): The doctors said they normally give a 11-point-something dose (but they gave me a bit reduced dose, due to my young age and my less-than-average activeness.) I can't remember what unit this was, does anyone know what unit you would normally use for this? They tested my blood sugar when I arrived fasting, and it was 4-point-something, which they said was in the very very good end of the normal. I don't remember the unit for this either, I thought it would be mmol/l (I heard somewhere that it is most used unit. I live in Denmark, but I don't know if we use a different unit-system?), but I found a chart where it put normal blood sugar levels at between 2.6 and 6.3, and in that case, it sounds more likely they used HbA 1c, where the normal is 4-6? Also, they said they wanted the insulin to give me bloodsugar levels just under 2, so if it was in nmol/l, then that doesn't seem that low. My blood sugar dropped to 0.8, which was much lower than they wanted (but a good sign for me, as it showed I was very sensitive to insulin=very low chance of getting diabetes). It makes sense that they would want the test-person to get hypoglycemia to make the hormones 'freak out', and I read that it occurs at 2.8 to 3.0 mmol/L, so that seem like what they were going for, so that points to that the unit might have been nmol/l. But then I read that 1-0 nmol/l is insulin-chok and will make you pass out and maybe even go into coma, and I was conscious and could talk the whole time (though I think I was a bit slow, because they asked me about what symptoms I was experiencing, and when I told them, they concluded "and you are also feeling very groggy"). I did manage to fall alseep very quickly though, because after my bloodsugar levels rose, they only tested my blood every 15min, and they had to wake me up a few times to do so. So if my bloodsugar was 0.8nmol/l, shouldn't I have felt worse? It wasn't that bad. So, my overall question is what unit it might have been, and also, do you think I had an insulin-chok, or just a bad case of hypoglycemia?

• Answer:

  What you had was an insulin tolerance test. It's very unusual to give such a test as it's very dangerous. They would usually only do it in preparation for surgery. The units for the glucose are mmol/L everywhere in the world except the US where they use mg/dl. In an ITT, they need to bring you below 2.2 mmol/L which is already a dangerous level. 0.8 mmol/L is a very dangerous level, it corresponds with 14 mg/dl. Normally you do not want to be below 3.9 mmol/L ( 70 mg/dl ) and levels lower than that would be hypoglycemia ( what used to be called insulin shock ). You're usually acting drunk by the time you're at 2.8 mmol/L and you're likely to pass out and go into a coma at that point. In your case, you had hypoglycemia, insulin shock is a very dated and somewhat inaccurate word for the same thing, but in your case it was intentional. Your levels did drop low enough to put you into a coma and possibly death. It may not have felt bad but it was. Note that the international standard for a HbA1C is mmol/mol while North America is still using the DCCT percentage but they have promised to switch over. So an HbA1C of 6.5% which is when it would be considered diabetic corresponds with 48 mmol/mol on the international scale. Note that the UK is now dual reporting the test results as both a percentage and on the international scale. The Scandanavian countries had another percentage system called the Mono S scale but they switched to the international scale in 2003. Insulin is measured in u's which stands for units. Originally a u of insulin was the amount needed to drop the glucose level of a fasting rabbit by 40 mg/dl. Insulin is often diluted to make it easier to measure, most insulins are called u100 insulin and there would be 100 u's in 1 ml. Insulin used to be available as u40 insulin where there was 40 u's in one ml. Today u500 insulin are available for pump users and because certain obese people have so much insulin resistance that they have to take hundreds of u's to have an effect. The amount of insulin you need to provide the energy for the day is called your total daily dose or TDD. It can usually be estimated by taking your weight and dividing it by 4. They probably gave you 11 u of insulin because that was a certain fraction of your TDD, possibly 20%.