My son, who is almost four years old, has had type 1 diabetes for almost a year. Can “growth spurts” drastically affect the blood glucose readings within that time? Also, is there such a thing as “rebound” numbers after having a low?

All children have an increased level of growth hormone over their growing phase causing insulin resistance and high blood sugar levels during the the night. This is very manifest during puberty, when the growth rate is most increased (the growth spurt of puberty, but is very limited in a four year old boy. In this case, larger doses of insulin are needed to meet the body’s demand.

Boys usually have their growth spurt around 14 years of age, but this depends on when they enter puberty. They require usually much higher doses during late puberty.

Within a few years after puberty, the insulin requirement decreases to an adult level. Therefore, it will be important to consider both insulin and nutritional requirements in relation to your son’s growth phase. Treatment with an insulin pump can considerably improve the metabolic control over the puberty years.

The sudden increase of blood sugar levels (posthypoglycemic hyperglycemia) after hypo (low) is due to the counter-regulation mechanism that the body puts into action to try to reverse hypoglycemia through counter-regulatory hormones. Also, when having a hypo, it is common to eat too much. It is also common to decrease the next insulin dose to avoid new hypos. Both these factors contribute to the rebound phenomenon, resulting in an even higher blood sugar level.

MS