"She's fine."

The doctor tested Sprout’s blood with a quick finger prick and a number that looked reassuring on the small screen. I remembered the same test on her tiny foot when she was a newborn ensuring my gestational diabetes hadn’t been passed to Sprout. Then as in now my worries about my blood sugar issues showing up in my mini me replica and the subtle symptoms I’d started noticing amounted to nothing really to worry about. Here was a doctor telling me I could stop worrying.

I wasn't wrong to worry. I was just looking at the wrong test.

Here is what I was not considering: insulin resistance shows up before blood sugar does. Long before. Your child's body can be pushing out more and more insulin, working overtime just to shuttle glucose into the cells, while every number on that standard office visit still reads normal. The metabolic system hasn't broken yet. It's just under strain. And a fingerstick, or even a basic A1C, does not show you strain. It's built to show you failure, once it's already happened.

So, if your gut is telling you something is off and the doctor's office is telling you the numbers look fine, you might just be holding the wrong piece of paper.

Here is a list of what to ask at that pediatric appointment. Bring it with you. Ask for all of it, even the parts that feel like you're pushing.

Fasting glucose: this is a standard check, and only half the picture

A1C: your average blood sugar over about three months. Remember, if your child has blood sugar drops it could be pulling down an elevated number and this does not catch high insulin at all

Fasting insulin: this is the important one, the one that catches this years’ early, before glucose is ever affected. This is not automatically given. You have to ask by name.

Full metabolic panel: cholesterol and thyroid function, both of which can be comorbidities with insulin resistance

Hormone panel: if your child is approaching puberty and you're seeing acne, irregular cycles, or excess hair growth, ask about testosterone and androgen levels. Insulin resistance sits at the core of PMOS (Polyendocrine Metabolic Ovarian Syndrome, what used to be called PCOS)

We are at the tail end of a six-month wait to see an endocrinologist, and when we finally get there, she will see Sprout for her thyroid, not for insulin resistance.  When one hormone is imbalanced it can throw off others…so how does this make sense?  If you're starting this process, ask directly, up front, whether insulin resistance itself is something the endocrinologist manages, or whether you'll be back to square one after the wait.

Dietitian coverage, in our experience, has been denied outright, because Sprout isn't diabetic, only insulin resistant. Check your specific plan before you count on this being available to you.

A nutritionist is the other option, and the guidance there tends to run newer, closer to current research. That can be a real advantage. It can also mean you're working from ideas that haven't had time to prove out the way older approaches have. Credentialing for "nutritionist" varies wildly by state, too. It's a real tradeoff, and only you can weigh it for your family.

There isn't a single right door here. I've walked through more than one myself, and I'll tell you honestly what worked and what didn't as we go.

If you walk out of an appointment with a "she's fine" that doesn't sit right in your stomach, trust that. The standard visit is built to catch diabetes, not the years of insulin strain that come before it, the years where your child is still catchable. You may have to ask for more than what's offered. You may have to ask twice and then ask again at the next appointment when the first doctor doesn't run it.

That's not you being difficult. It is you standing up for your child and demanding tests that would catch what a five-minute visit was not meant to address.

Keep following along or subscribe as I cover the programs, apps, tools and tips I looked into for Sprout, including the one I chose to walk away from, and why.

Until next time,