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From Georgia, USA:

Our son is 11 1/2 and has had IDDM for 4 years now. It seems that now as he starts to go into a growth spurt we have a very difficult time with control. What are some ways to assist with tight control during these growth spurts?


Insulin needs are constantly changing during adolescence, especially during periods of rapid growth when both insulin and food requirements may increase rapidly. This is also a time when many teens find the demands of strict control particularly difficult.

The most important thing is to keep in close frequent contact with your child's physician, to meet with a dietician to update his meal plan with growth and changes in activity, and to keep open the channels of communication between you and your son. If your son is willing, he may want to try more intensive management with more frequent injections.

Although I agree completely that everyone with diabetes should aim for as close to normal blood sugars as possible, I think it is important to keep in mind that completely normal blood sugars are rarely possible with the present methods of diabetes care after the remission or honeymoon period wears off, especially during adolescence. It is also important to remember that if you try too hard, you may experience severe low blood sugars.

Even in the Diabetes Control and Complications Trial, only 4% of the adults in the "intensive treatment" protocol were able to maintain their HgbA1C in the high normal range. The average HgbA1C in the intensive treatment protocol in the adults was 7.1% (non-diabetic < 6.05%) The adolescents in the intensive treatment group averaged higher than the adults at 8.06%. Sixty-three percent of the adolescents in the intensive treatment group experienced at least one episode of seizure or unconsciousness due to a low blood sugar. Eighty-two percent of the adolescents in the intensive treatment group had at least one episode of low blood sugar severe enough that they required assistance from someone else to treat the low blood sugar. This demonstrates the frustrating problem that if you try too hard for normal blood sugars, you may overshoot and experience a severe low blood sugar.

It takes a lot of patience and work to obtain the best blood sugar control possible while still avoiding severe hypoglycemia, but it's worth the time and effort.


Original posting 18 Dec 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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