Q: Our 12-year-old daughter is going through a growth spurt, and no matter how carefully we monitor her blood glucose, her numbers seem like they’re all over the place. Are these two things connected?
A: The short answer here is yes, it’s common -- and completely normal -- during growth spurts for adolescents with type 1 diabetes to experience fluctuations in blood sugar numbers. As for why this happens, the medical part of the explanation is pretty straightforward.
When children enter puberty, their bodies begin producing increased amounts of growth hormones to assist with maturation. We know that growth hormones can affect the body’s sensitivity to insulin and sometimes make it so that more insulin is needed in order to regulate blood sugars. During a growth spurt, levels of growth hormone tend to peak and make this insulin “insensitivity” even more pronounced. In adolescents without type 1, the body’s response to all this is to simply produce more insulin if needed. In adolescents with type 1 diabetes, however, it’s often necessary to make adjustments in insulin doses to keep kids’ blood sugar levels within range.
Frequent monitoring of blood sugars can help tell you what kind of dosage adjustments may be needed, as well as show patterns emerging in your daughter’s numbers over time. It’s a good idea to check in with your diabetes care team to share this information and discuss how best to accommodate growth and maturation.
And now for the not-so-straightforward part. At the same time adolescents experience great physical change on their way to becoming adults, they are also experiencing tremendous changes in their social and emotional outlook on life. Sometimes a high blood sugar number isn’t due to a growth spurt at all. It could be that a child ate out with her friends and didn’t cover the food with insulin because she didn’t want to stand out as different, or she is secretly snacking at home because she finds the family rules around food too strict.
In situations like these, it’s best not to engage in battles over the issues. Instead, do what you can to have more meaningful, nonjudgmental conversations with your daughter about how she’s feeling about life in general and about her diabetes. This information, combined with blood sugar numbers, can show a fuller picture of how best to get your daughter through this hormonal transition into adulthood, which -- believe it or not -- can last until your child is in her early 20s!
--Cydney Fenton, M.D., is director of the Center for Diabetes & Endocrinology at Akron Children's Hospital in Ohio.
How Other Parents Deal
“Now that it’s obvious he’s hit a growth spurt, every week we measure our son’s height on the same doorframe where we used to measure it when he was little. He may roll his eyes, but I know he loves seeing that pencil mark get higher. It helps me, too, to see that the reward for this challenging time is a son who is growing tall and healthy.”
-- Lisa M., Delmar, N.Y., mom of 14-year-old Daniel
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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