I'd written a few weeks ago confiding my frustration with my teenage son who has Type 1, and dealing with what I felt was his poor management of his diabetes. I found myself at the end of my rope in figuring out how to deal with his erratic and increasing BG numbers.
At the time of that writing, I had no insights or thoughts (beyond my ire), although at least one reader was hoping for a list of recommendations. Dr. Fran Cogen, using her wealth of experience, supplied suggestions.
Now, six weeks and a trip to the Endo later, not to mention some time to reflect on the situation, I do have leads into why his BG levels were increasing. I've been struck hard by the disconcerting realization there was no silver "bullet" answer as to why his BG numbers were shooting higher and higher. The reasons were diverse - probably both physical and emotional. Even more unnerving is dynamic nature of the situation, which is to say what the answer is today, may not be so tomorrow.
With that said, I do want to share what were the many interwoven factors that were causing my son's BG levels to be more often than not in the 200s - and even 300s. Do note that the following are only surmised contributors to what may have caused his increase in BG and does not list an action plan, because, as mentioned above, I believe every situation is custom and dynamic.
First, the obvious ones:
- Not checking BG levels regularly: This could have been due to regular, old-fashioned teenager rebellion. More than likely, this lack of checking was due not only to rebellion, but also to "Diabetes Burnout," which my son admitted when he blurted out, "I am so sick of this!" and slammed his BG monitor on our kitchen counter.
- Poor food choices: There's no doubt that being a part of the teenage world played a role here. Not wanting to be different, my son admitted that he forsook his packed lunch for a huge Otis Spunkmeyer cookie, just like the rest of his friends did. We figured out what he was doing when we reviewed his lunch account online and found that a cookie had been purchased, which he had previously assured us were for his "friends."
And then, the not so obvious contributors:
- Emotional distress: Unfortunately, stress can impact BG levels in the blood and cause them to rise. This is in direct correlation to the "fight or flight" response that has been programmed into us. A few things were stressing my son. First, he was not dealing well with not telling us the truth about not keeping his records and not eating the way he was supposed to. Secondly, he was not doing well in math, which is a class he'd always fared well at before. Consequently, he'd not turn in his homework for fear that he'd get it wrong and receive a poor grade and to top it all off, he was performing poorly on exams.
- Growth: Having shot up six inches in the last year, my son is now wrestling with one of the biological causes to a teenager's high and erratic BG numbers: puberty. The pancreas produces twice as much insulin during puberty as at any other time in our lives. Much of this high production has to do with the appearance of, and increase of, growth hormones.
- Pooling of insulin: My son has a wiry build containing few fatty areas and consequently he has few areas to choose into which to inject his insulin. He was building up hard lumps around his favorite injection sites, which was causing his insulin to pool under his skin instead of being absorbed.
- Change in routine: It's a known fact that exercise can positively affect and lower BG levels in the blood. During his summer break, my son regularly took long walks, sometimes up to 90 minutes to two hours, with our dog. With the start of school and the start of a new schedule, the length and frequency of these walks were shortened - much to the chagrin of both our son and dog.
I fear that there are additional factors that we have missed, but I suppose that's all a part of this wild, unpredictable ride.
Published On: November 30, 2009