Question from Mt. Pleasant, Texas, USA:

My 11 year old son was diagnosed when he was two years old. We’ve had our ups and downs, but, overall, have never experienced major complications. I credit this to our structured approach over the years of maintaining good carbohydrate counts, a healthier diet/exercise, and a good control/testing of blood sugars for my son. But, there are a couple of questions lingering on our minds now and we’d like your opinion.

About five months ago, my son’s insulin regimen was changed from NPH/Humalog to Lantus/Humalog, mostly because he was suddenly recording higher and higher overall blood sugars. This change produced greater control in his A1c, from a high of 8.5 to 7.5. This was done as a suggestion from a new endocrinologist and we were very pleased with the results. Over the past two weeks, he has been experiencing lows when waking up (40 to 60 mg/dl [2.2 to 3.3 mmol/L]) and after eating breakfast, with no Humalog whatsoever. We’ve even given bedtime snacks, up to 20 g of carbohydrates to try to avoid the morning low. Now, we are playing an insulin game, to the extent that it is becoming a risk to give Humalog, as normal, at breakfast, because of the lows he is continuing to experience. We went through the honeymoon period years ago when he was a baby, and from all my research, it seems that it is not possible for his body to begin producing insulin again, assuming all islet cells are now destroyed in his body. Call it mother’s intuition, but something is going on here. Are there any cases ever documented, worldwide, that the body could indeed produce insulin again, even small amounts, after nine years of type 1 diabetes?

My second question is regarding his growth. He is entering the puberty phase, beginning with the tale-tell pimples on the face. We have been very concerned over the growth of his penis, as his is smaller than his six year old brother’s and much smaller than the average boy his age, which has already resulted in teasing. We’ve been told time and time again that this is in no way related to diabetes. But, since the change in insulin management, his overall growth in height/weight jumped in just three months. Maybe this was happening due to normal growth patterns, but are there any cases where diabetes caused any decreased blood flow to the male genital area, causing growth problems? I read about the impotence in men and see that other parents share my concern about their own preteen boys. What kind of questions should I ask my doctor? They generally dismiss this, but should I have anything checked – growth hormones, thyroid, etc.? As a woman, I have no idea what predicates the size of a man’s penis, but am genuinely wanting to do whatever possible at this stage to ensure his best chances at a “normal” growth.