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Re: [IP] Need help with pre-pubertal control



<snip>
> Cut to the chase...Stephanie's insulin requirements have increased
> steadily over the last 3-4 months, with some basals increasing as
> much as 200% and now she's out of whack again! Came home from school
> several hours ago with a 543 (ouch!), slight ketones, and is only
> now beginning to come down slowly. This is only the most recent of
> several episodes...site is new, insulin is fresh, no signs of
> illness, etc. Could puberty be causing this much havoc with her
> numbers? I don't mind increasing her basals yet again, but I've not
> been able to find anything that supports an increase of this
> magnitude. 

Short answer, YES to above. Lily started pumping at age 11 1/2. Over 
the last 7 years I've seen all of what you describe and more. 
Sometimes the changes are long term, sometimes only a few weeks. I 
have seen insulin requirements double over a period of a week, only 
to go up again a few weeks later. At one point she was using 70 - 90 
units of insulin a day and running night time basals of 2u/hr -- she 
also grew almost 4 inches that year. Currently using about 50 u/day 
with basals of .5 to 1.0 over the day.

Don't discount a winter cold or something like that adding to the 
hassle. Try correcting with tmp basals first and if it looks long 
term, adjust accordingly. We generally were able to make 0.1 - 
0.2u/hr adjustments without doing complete basal profiles and still 
maintained good overall control. It seems that the timing did not 
change for us, only the amount of insulin delivered. NOTE: as basal 
insulin requirements go up, the carb/insulin ratio will come down a 
bunch. make sure to measure and change this as well. Your records of 
HBS boluses can be used to tweak that value. Carb bg numbers did not 
seem to change as much.

> Anyone else have this sort of experience or any other
> general advice regarding young females and diabetes (tried hiding in
> the closet during my older daughter's non-D puberty...didn't help,
> so guess I'm looking for diabetes related suggestions.)
> 
> Please cc your reply to me privately at email @ redacted since I
> am too busy testing and pushing liquids to check all the digests!
> 
> Thanks for your help everyone!
> Betsy
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