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Question:

From Niles, Ohio, USA:

My 11 year old daughter was diagnosed with typeá1 diabetes at the age of five. For the past three weeks, her blood sugar has been erratic ranging from 300 to almost 600 mg/dl [16.7-33.3 mmol/L] during the day. Her eating habits,exercise, and school have not changed prior to this. How much do hormones affect blood sugars in a girl this age?

Answer:

I presume you mean hormones of puberty (estrogen primarily in girls -- but they also make some male hormones, too). Yes! Those pubertal hormones can play a large role, but not usually the sudden and dramatic changes in glucose as you imply.

I'd consider looking at more immediately rectifiable solutions for now like:

  1. Changing bottles of insulin. After opening, Insulin bottles should be replaced every 30 days. Even if you have had a relatively new bottle, if things go funny suddenly, I'd look for "bad" insulin as the culprit first.
  2. Look for a concurrent illness. Her physician can guide you here.
  3. Watch the meal planning really carefully. Extra snacks or timing of meals during the crazy holiday season?
  4. Teens (and pre-teens) do periodically miss (or even deliberately omit) doses of insulin, and would never admit to do doing so. Sometimes it is attention seeking; sometimes to get ill enough to get to miss a test a school, sometimes as a matter of weight control -- especially, it seems, in girls. Can you actually provide her the insulin injections for a week and see what her sugars do?

If she has glucose readings this high, I hope you are checking her urine (or blood) for ketones.

DS

DTQ-20011130110328
Original posting 6 Dec 2001
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:30
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