Growth spurt/changing insulin needs

Our son, age 10 was diagnosed about 3 years ago, and he's on a minimed pump. His numbers had been pretty consistently good for a couple of months, then at Thanksgiving he was all of a sudden through the roof (frequent 300s and 400s). We thought this was due to the change in his routine and diet with bigger meals and desserts, which we don't do all that much. However, since school started again he has still been high, which is making us think he's having a growth spurt. I have a couple of questions:

1. Is there any reason a growth spurt might coincide with a holiday? Can changing diet precipitate a growth spurt? This seems unlikely to me, but so does the coincidence of a growth spurt starting the same day as a big change in his daily routine.


2. During a growth spurt is it just the basals that need changing? Or do growth hormones increase insulin resistance and so his corrections and carb ratios need to be modified as well?


3. His highest basal (in the early afternoon) is now .8 u/hr, which seems crazy high to me. Is this unusual for kids, particularly ones on the small and lean side (which he is)? I am hesitant to go  that high, but yesterday seemed pretty definitive as he didn't snack after lunch at 1 and continued to go up in the late afternoon even after corrections (and his lunch was not terribly high protein or fat).



Think the holiday was just coincidence.

Growth hormones (and reproductive hormones that he'll deal with in puberty) cause insulin resistance.  So you'll probably need to adjust basal and then give correction doses until you see where his insulin needs settle.

Might be best to call his doctor/diabetes educator for specific recommendations on adjusting basal and carb ratio.  

Bruce: I hope things have settled down some with your son. My son is 12 and he was diagnosed 2 years ago at the age of 10. Your son is definitely at the stage where hormones could play a significant factor in, well just about everything. My son was going through the exact same thing, at the same time, when you posted this so I didn't want to post my answer too early. Chances are that your son's change in routine played more of a role in his unexpected highs than anything else. Once my son started back to school it took him just about a week for his body to get back into his school-time routine vs. his lazy-time routine. I played around with his carb ratios for the first few days to help waylay some of the highs and then all of a sudden he started running low so we were back to the pre-holiday ratios. Since basal insulins are long-term then I wouldn't make any changes to that without first talking to his endo and voicing your concerns to them. They would be the best ones to determine how much needs to be changed, or if it's just something that needs to be waited out a little longer.