June 11, 2003
Puberty
Question from Indianapolis, Indiana, USA:
My nephew has type 1 diabetes. Is it always necessary to increase the insulin dose when a child with type 1 diabetes starts puberty (growth spurt)?
Answer:
One does not arbitrarily increase insulin doses for puberty, but it’s very common to see relative insulin resistance from the growth hormone surges, among other hormones that change. When this happens, blood glucose levels rise, and the response of extra insulin needs is predicated upon seeing higher blood glucose levels. These changing needs are to be expected — but exactly and how much of a change in insulin dose is needed is very individualized.
SB
Additional comments from Dr. Donough O’Brien:
Increased growth means an increase in body mass and thus an increase in basal insulin needs. As always though, the dose of insulin has to be determined on the basis of how best to control blood sugar throughout the day.
DOB
