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Question:

From Rochester, New York, USA:

My son's pediatric endocrinologist thinks my son may have MODY. However, he hasn't ruled it in or out yet. Here's what's going on: My son had a serum insulin level done fasting. His blood sugar was 139 mg/dl [7.7 mmol/L] while his insulin level was non-existent. They repeated test two hours after a meal and found that his serum insulin level was 36 while his blood sugar was 150 [8.3 mmol/L]. His C-peptide was 6.8. My son, who's five, weighs only 35 pounds, four less than he weighed before this started. He has been having erratic blood sugars, from 243 mg/dl [13.5 mmol/L] to only 43 mg/dl [2.4 mmol/L]. Some have been while fasting. He averages 150 mg/dl [8.3 mmol/L] during the day, well into the 200s mg/dl [11.1 to 16.5 mmol/L] after a meal, slowly returning to the 150s mg/dl [8.4 to 8.8 mmol/L].

He also goes through a phase where he loses his appetite, complains of stomach pain and refuses to eat. I force him to eat and drink something. This often leads to fasting blood sugars in the low 40s mg/dl [2.2 to 2.4 mmol/L].

Is this MODY? He's too thin to be type 2, but, typically, doesn't type 2 mean high insulin levels because the insulin is "sluggish" so the body just dumps it out? The endocrinologist isn't telling us anything.

Answer:

This certainly sounds frustrating and not very typical. However, I would suggest that you make a special consultation appointment with your endocrinologist and ask these questions since the endocrinologist is the only one who can answer these. Close monitoring will help. There are some special genetic tests for different MODY types now available if islet cell, GAD and other antibody tests are negative. Unfortunately, even in type 1 diabetes, not all such antibodies come back positive. So, go back and have a detailed consultation so that you can map out a therapeutic plan.

SB

DTQ-20051109210226
Original posting 13 Nov 2005
Posted to Diagnosis and Symptoms and LADA and MODY

  
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Last Updated: Tuesday April 06, 2010 15:10:04
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