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.