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    non-diabetic Child with 300+ insulin on OGTT???
    avatar
    An_246684 posted:
    Endocrinologists say her numbers do not make sense and are at a loss at this point. Would love an opinion on where to go from here.

    11y/o female with unexplained weight gain for past 6 years.

    Fasting OGTT with 75 gram glucose drink: ( This was done twice due to high insulin levels, with similar results )

    Glucose:
    Fasting specimen 66
    1 hour specimen 102
    2 hour specimen 107

    Insulin Response to Glucose:
    Fasting Specimen 23
    1 hour specimen 215
    2 hour specimen >300

    Leptin 42.5 (high)

    C-Peptide 3.09 (normal)


    Lots of bloodwork, everything else basically normal. Strange that C-peptide is normal, but insulin is outrageous. She is on NO medications and no exogenous insulin.

    Also had negative MRI of pancreas.

    Thanks for looking and for your thoughts.
    Reply
     
    avatar
    flutetooter responded:
    I'm NOT a doctor, but I just checked the web for information onf "High post prandial insulin level". You could do the same to bring up questions to ask your endo. One article mentions that excess body fat can contribute to this, and another said that High insulin levels after a meal in a person with no known diabetes seemed to be a marker for future coronary heart disease.

    In any case, you know that something is out of balance in your daughter's body, especially with that weight gain. It is good that you are seeking answers. Keep pushing until you find a doctor who is interested in finding the cause. In the meantime, encourage your daughter to lose some weight and exercise and eat much less starcy and sugary foods like soft drinks, white bread, cereals, potatoes, rice, desserts.
    If at first you don't succeed, try, try again!
     
    avatar
    mhall6252 responded:
    Has her thyroid been checked?
    Michelle
    Diabetic since 5/2001
    Follow my journey at www.mch-breastcancer.blogspot.com
    Smile and the world smiles with you.
     
    avatar
    outdoorbaby replied to flutetooter's response:
    Thank you for your input

    Oh yes, she mostly follows a paleo diet, which is lean meats, nuts, non-starchy veges & occasionally fruit (only 1/2 cup at a time and that is usually berries). If she does have fruit or a small amount of gluten-free cereal, she never eats it w/o a protein. She is allergic to gluten and casein, so she very rarely eats gluten-free bread and seldom eats a small amount of cheese. She ONLY drinks water...never juice or soda. Her diet has always been fabulous and she is a VERY active child. That's why none of this makes sense.

    She recently started following 20g protein & 20g carbs per meal and has 2 snacks of 10g protein and 5-10g carbs and she has lost some weight with that balance.

    She is more knowledgeable about nutrition than most adults even. I am very proud of her that she has a healthy mindset and approach to the food situation.

    The endo says she has no markers of co-morbidity. It is frustrating but we will not give up.
     
    avatar
    outdoorbaby replied to mhall6252's response:
    Yes, several different thyroid markers checked and everything is within normal limits....it was on the low-end of normal so she was put on 25mcg of Levothyroxine as a trial, but it made her "moody" with no other noticeable benefits, so it has been discontinued. She is not currently on any other medications, other than fish oil to help with insulin/blood sugars.
     
    avatar
    Anon_74671 replied to outdoorbaby's response:
    have they checked for an insulin producing tumour?

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001424/
     
    avatar
    Michael Dansinger, MD responded:
    Wow! I'm stumped too!
    Please let us know if you get any answers.

    It is frustrating when the doctors don't have answers, especially when it is your own child. I'll let you know if any suggestions come to mind.
     
    avatar
    outdoorbaby replied to Anon_74671's response:
    She had a negative MRI of the pancreas (which apparently doesn't show a tumor most of the time anyway...I think CHOP has a PET/CT scan they can do, but only if it is highly suspected, because there are radiation risks that go along with that).

    C-Peptide is normal....it should be about 5x the amount of insulin. She also does not have severe hypoglycemia, which they say is typically present with a tumor. One doctor thought tumor. Another doctor thought that was way off base....so....still searching. Somewhere I had read about the possibility for an autoimmune disease falsely elevating an insulin level. I need to research that more.

    Thank you for that idea...it is definitely a valid consideration.
     
    avatar
    An_246684 replied to Michael Dansinger, MD's response:
    Thank you. It is extremely frustrating. I know that life is a giant mystery and we are all in this together. I appreciate you taking the time to look at this and would definitely love suggestions if anything comes to mind, or if you happen to run across anything similar.
     
    avatar
    Haylen_WebMD_Staff replied to An_246684's response:
    You might also want to check in with our expert in the parenting community. He might have come across this in his practice:

    WebMD Parenting Community

    Your daughter is fortunate to have a proactive, persistent parent in her corner! I hope you find answers soon - please let us know when you do or if other issues come up.

    Haylen
     
    avatar
    outdoorbaby replied to Haylen_WebMD_Staff's response:
    Thanks so much Haylen....that's a great idea.
     
    avatar
    amenowanna replied to An_246684's response:
    Did you ever find an answer to this mystery?


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