Question from Rockport, Indiana, USA:

My 12-year-old son has missed a lot of school through October. I’ve had to pick him up numerous times due to symptoms of fatigue, headache, nausea, and light headedness. Sometimes, his blood sugar is high; sometimes, it is not. He is on an insulin pump. His endocrinologist made changes to his basals a couple of weeks ago. His blood sugars have improved. The symptoms he experiences almost every afternoon persist. He’s almost 13. Could his problems be related to puberty? He’s also had several viral infections this year, including sore throat and a stomach bug. He was screened for mononucleosis earlier this year. The persistence of the fatigue is very worrisome. He’s gone to his general practitioner for each viral episode; they don’t seem too concerned. What could these symptoms be?