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March 20, 2006

Diagnosis and Symptoms, LADA and MODY

Question from Trenton, Ohio, USA:

My five year old daughter had a check-up a few weeks ago. I talked to the doctor about her wetting the bed. He did blood work which all came back normal, but he is sending me to a endocrinologist. The doctor told me to check her sugar until then. Her readings are from 80s to 130s mg/dl [4.4 to 7.7 mmol/L] in the morning and 99 to 210 mg/dl [5.5 to 11.7 mmol/L] one to two hours after dinner. There is a strong history of diabetes on my side and her father was diagnosed with type 2 about three years ago. Could this be MODY or just abnormal readings with nothing to worry about? She is thin and goes through stages of drinking and eating a lot. Sometimes, she will not eat anything, but always drinks.

Answer:

MODY usually has a direct line of family members, child, parent, grandparent, etc. There are some new genetic tests for different types of MODY available from places like Athena Diagnostics that may be helpful. Testing for islet cell and GAD 65 antibodies may also be helpful, but only if positive; not everyone has positive antibodies, however. The blood glucose readings you report are definitely not normal, but intermittently abnormal. You should discuss these directly with your diabetes team and work closely with them, perhaps on a meal plan, but certainly with some on-going monitoring. It could also just be the beginnings of diabetes that you have caught rather early. Time will help sort this out.

SB