March 20, 2005
Exercise and Sports, Hypoglycemia
Question from Bethlehem, Pennsylvania, USA:
Our son, age 11, a type 1 diabetic, recently has been running low blood sugars. He had been participating in a basketball program and, generally, his blood sugars would be running low after basketball games and for up to 12 hours afterwards. His last game was Friday, February 18, however, he still is running low. For example, this morning he tested at 90 mg/dl [5.0 mmol/L] at breakfast. Two hours later, he called from school and he was 60 mg/dl [3.3 mmol/L]. He drank a juice box or 25 grams of carbohydrates and was 101 mg/dl [5.6 mmol/L] 20 minutes later. He also has a slightly stuffy head. Usually, his blood sugars are high when he is sick. His carbohydrate to insulin ratio is 10:1 and his correction factor is 50.
Could the beginning of puberty cause his blood sugars to run low? He was diagnosed at seven years old in September 2001. He was on injections until December 2003 when he started on an insulin pump. The last time he met with his PCNP in August of 2004, she stated that he was showing very early signs of puberty.
Answer:
No, puberty would not typically lead to enhanced responsiveness to insulin. In fact, if anything, more commonly puberty leads to larger insulin requirements.
My guess is that the exercise is really playing a large part here, emphasizing to you (and anyone else who reads this) just how important a bit of exercise is in helping to control blood glucose!
Assuming that your son has not had obvious intestinal issues (to interfere with food absorption) and is not taking any other medications, supplements, health-food products, etc., then it might also be reasonable to discuss with your diabetes team the potential considerations for some co-morbid issues that are common in type 1 diabetes to include thyroid diseases, adrenal gland insufficiency (see Autoimmunity and Childhood Diabetes), or Celiac disease.
DS
