What is the significance of a fasting blood insulin level less than two when the lab range is six to 20? My three year old daughter’s blood sugar fasting was 72 mg/dl [4.0 mmol/L], but with the low insulin. Shouldn’t she always have SOME insulin in her bloodstream? She is antibody negative at this time with blood sugar ranges from 70 to 280 mg/dl [3.9 to 15.6 mmol/L] intermittently along with classic symptoms of frequent urination and thirst.

Low levels just mean what that suggests. With normal blood glucose levels, the insulin levels usually should be in the single digits. The assay is somewhat variable, so specific numbers individually are not so helpful except in relation to the blood glucose taken simultaneously. High insulin levels with low blood sugars is worrisome for excess insulin conditions that cause problematic hypoglycemia. Low insulin levels with high blood sugars suggest beta cell compromise and some sort of diabetes evolving or a “thermostat” that is not registering and adjusting itself properly. Low insulin levels with normal blood sugars are the most difficult to evaluate since this could be normal or may just be transient phenomenon.

The blood glucose levels you describe are definitely not normal, so her risks of future diabetes would seem high. You should review this in detail since the specifics for her are critical to understanding these complexities. Please ask these specific questions of your medical team since they can explain them in much more detail and not just generalities.

SB