Puberty and Unexplained High BG and Ketones

We are having a heck of a time with my 12 1/2 yr. old son. He is experiencing frequent days with high BG readings and ketones. No variables are present with eating, activities and not ill (no cold, flu etc.) We have changed basals, changed ratios, in close contact with endo on all. We even went to GP and did blood work and took x-rays (fortunately nothing amiss was found). We are left with questions and a good deal of frustration. Can hormonal fluctuations be the cause of all of this? Our endo isn’t buying it but meanwhile has no explanation to offer.

The endo is smart to be skeptical. Is he suggesting a CGMS or pump? The times, durations, the preceding activities, etc. also play an important part in BG fluctuation.
One does find out important causes of fluctuations when one wears a monitor. And a little notebook in which he records his up and down feelings to go along with times of day should be added.
Eating at school can be an awful stressful time and choices may be awful… Lots of friends? Or stresses caused by personalities of friends?
I could go on and on with behaviors of cohorts of 12 - 13 year olds, as I’m sure you can, too.
If the Endo hasn’t recommended getting further information with the CGMS - and using a pump, as indicated, bring it up to him/her.
Best wishes to you as you get to the bottom of it.

Thanks. Our son has been on a pump since May. He had excellent control with it until the school year started. He brings a sack lunch every day, so the cafeteria food is not the culprit. We have an endo appt this afternoon. Hopefully we can make some headway.

Joel - I’m thinking it’s hormones. As I went thru’ the same thing at his age, except we didn’t have all the gizmos that are available to you now for keeping tighter control on your children. When I turned 10, my Mum basically trusted me to do my urine testing, once a day shot of NPH. Times have changed, we are better educated, and sadly there are more Type 1 diabetics now compared to back in the ol’ days!

I know that I went abit off the wall at 12 - by I guess - trying to be NoRmAl - and unlike your son - whose not got flu or anything. For me, a whole year of getting “flu” - well - you know what was happening - I was hanging out with friends at the Pop Shop, Candy Store, yadda, yadda, yadda. Finally my body just said “Enough” - and I ended up in a coma for 3 days. My Mum of course got heck for allowing me to get this way, but it wasn’t her fault, it was mine. Still feel bad to this day, that I put here thru’ that. Both my parents worked, and I was left to take care of myself, as they thought I was responsible, but obviously I got smarter after that experience! Good thing, no harmful results from it, I’m blessed with good genes (Levis ).

Anna from Montreal - aka FatCatAnna - The Trials and Tribulations of a Diabetic

I wouldn’t be surprised if starting hormonal changes going into puberty is the real problem, happens to many at about that age, BUT of course he might be getting more “independent” about what he eats, keeps track of or whatever. Seems that is very common about that age too…
Myself I finally got under control at about that age, but that was because my endo found a (for then) absolutely different meds regimen to straighten me out. I took a pill with each shot, morning and night. That WAS in 1962 mind you, and the pill was Phenformin (a poor relative of Metformin, since then taken off market) with a medium speed insulin. Oh well, ancient history, and a pump is a much better way to control if used well. Been using pumps for almost 16 years now, and it’s a world of difference.

I am pretty sure puberty will affect insulin use. Growing, weight, and muscle gain will change his requirements - for sure.

on another note, how’s he doing with diabetes, I mean, he’s 12. There could be anger issues, “sneaking” sweets, wrapping your head around the idea that “he has this, his friends don’t and it’s not going away” can be a challenging time for him,… it was for me. More notebooks, draconian security measures, micromanagement, etc., could also make it worse. I am not saying you are doing anything wrong, but pressure could have something to do with it maybe? How independent is he? How is his desire to become independent? I do not mean any offense - just offering my thoughts. good luck.