October 6, 2000
Daily Care, Puberty
Question from Deer Park, New York, USA:
My 12 year old is severely autistic and has type�1 diabetes, diagnosed three years ago. He has been in fairly good control. About a month ago, his glucose readings started fluctuating wildly. He went low on me all day, even with taking readings frequently, treating the low, and following up with snacks. Since then, approximately once or twice a week, I have problems with him being low. The following days, his readings are high, 200 to 300 mg/dl [11.1 to 16.7 mmol/L]. His doctors tell me that he is in the range they want to see him in (100- 200 mg/dl [5.6-11.1 mmol/L]), but, since he can’t tell me if he is low, the whole situation is very frightening. Is this a common occurrence? Why were his numbers so easy to control previously with insulin adjustments and carbohydrate counting and now everything is haywire?
Answer:
Sounds to me like your son had a prolonged honeymoon. He made some insulin which helped smooth out the edges. You weren’t giving a lot of insulin so he was protected from lows, and he made a little to keep the highs away. The other reason may be that he has an undiagnosed infection. Teeth are famous for this, sinuses and even tonsils. If it’s real diabetes, it will be harder…try to avoid the lows even if the average is a bit higher than you’d like.
LD
[Editor’s comment: He may also be entering puberty. Hormones that come into play during this life stage often make control very difficult.
WWQ]
