My blood sugar is always between 10 mmol/L [180 mg/dl] and 16 mmol/L [288 mg/dl]. I am 12 years old and I am going through puberty. Is puberty affecting my blood sugar? My doctor tells me to correct my insulin, which I am doing, but it isn’t making any difference! Can you please help me?

Puberty does affect your blood glucose in several ways. With puberty comes the production of the sex hormones, testosterone (primarily in boys) and estrogen (primarily in girls). Both genders make both sex hormones. These pubertal hormones do not allow insulin to work as effectively as it did before puberty. In other words, a degree of insulin resistance occurs. The usual effective treatment is to give more insulin than had been necessary. You did not indicate the insulin doses or calculations you use, but, if for example, you typically “correct” your doses by giving an extra few units of insulin, you probably will have to give more, perhaps 10 to 20% or more. Some of this will be trial-and-error, but your diabetes team should be able to give you some guidelines.

Furthermore, appetite tends to increase with puberty, especially to fuel the growth spurt that will be coming. Increased food means increased need for insulin.

Now the good news – especially if you are a boy: with puberty comes the opportunity to increase muscle development. Muscle helps to enhance the effects of insulin. More good news is that when puberty is complete, and as long as you stay fit and trim, your insulin needs won’t change too much. If you get heavy and/or become inactive, your insulin needs will probably increase with time.

DS