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tavia vital

Public Service Announcement:  Growth Hormones and Sleep Deprivation

 Attention “New to Diabetes” Parents or Guardians of a child with Type 1 Diabetes:  If you haven’t heard yet, growth hormones can severely impact your quality of sleep. (1)  As a public service announcement, I want to ensure you have proper knowledge about and a plan to address this challenge.

According to a recent survey, almost nothing is more important than a good night of sleep to those of us with diabetes, or those of us caring for someone with diabetes. (2)

As a parent or guardian of a child or teenager with Type 1 Diabetes, the list of things to worry about and prepare for in your child’s day-to-day life can sometimes feel daunting.  When you really stop and think about the nearly never-ending list of things that can impact glucose levels, it is just about too much to deal with sometimes.  Need an example of what can impact glucose levels?  Check out DiaTribe’s 42 Factors that Affect Blood Glucose. (3)

As a parent of a growing teenager with T1D, growth hormones are my biggest adversary.  We can be streaming along moving through each day like Diabetes Bosses.  We have it down.  Pre-bolus timing, extended boluses, increased temp basals, decreased temp basals.  Life event?  We have a strategy!

Then a period of growth happens.  Sometimes the growth hormones trickle in like a light rain shower in the springtime.  Other times it seems like the growth hormone changes come roaring in, charging like a ferocious lion, or screaming in like a Derecho. (4)

boy height

First, like every astute parent of a child with T1D, you go through the blame game.  This is especially easy to spend too much time on if you are short on sleep, busy with work, or caring for other family members.  Thoughts swirl around in our minds like the incessant whirlybirds of the maple trees seen this time of year.

  • “Oh, we likely underestimated our carb counts today because we were busy”
  • “The food was challenging to count since we had to eat out due to our busy schedules today”
  • “Maybe the site/pod needs to be changed”
  • “Did the insulin get too hot?”
  • “Is the site dislodged since he’s been playing a lot of basketball and foursquare?”
  • “Does anyone know how old that vial of insulin is? Why didn’t we write the date it should be thrown out on it in marker!?!”
  • “I should have told him to increase his dose more due to the portion of protein in that gigantic meal he wolfed down.  Where DOES all that food go?!?”

Suddenly the thought arrives in my mind like a flash of lightning in a Midwest thunderstorm in May!  “HE IS PROBABLY GROWING!!!! THIS ISN’T OUR LACK OF DIABETES SKILLS!!! HE JUST NEEDS MORE INSULIN!!!”

How much more?  First, we try our usual methods of calculating settings adjustments.  Close to target and just a little off?  Adjust by just a little.  To have a better understanding of how to identify whether basal vs carb ratio vs correction factor adjustments are needed, and how much adjusting is needed, check out Think Like a Pancreas, or contact your friendly Diabetes Care and Education Specialist.

After just one day of cautious adjustments that may have worked well in the prior few weeks, it becomes 100% clear:  small adjustments are NOT going to come close to what is needed at this time.  After a hailstorm of texts and calls back and forth over several days, my son and I started making SERIOUS insulin settings adjustments.  With each adjustment, we triple-checked the settings.  I now have enough photos of pump settings to likely make some sort of strange-looking pump settings flip book5.

settings

My son needed about 6 units of basal total over 24 hours each day to 10.25 to 13.5 units of basal in a period of about 1.5 weeks.  With the additional bolus settings adjustments needed he went from about 18 units per day to about 30 units per day.  To get through that rapid upswing in insulin needs, let’s suffice it say we have both really been shorted a lot of sleep time lately.  We shared a myriad of texts with complicated settings adjustment recommendations from me and fantastic pictures with messages like, “Really great news, mom!  My glucose isn’t really 400. It’s only 282!” from my son.

If I take a step back and look at what we really navigated through I can say, although I may be more tired than usual, we make a really excellent team!!  With all of my pestering, question asking, and double-checking, my 14-year-old did such a great job with replying, following my instructions, and asking for clarification questions whenever he needed to better understand something.  Now I’ll just be losing sleep thinking about when we will need to buy the next size up in shoes and clothing for him!!!

From one mom of a teen with T1D to another parent of a child with T1D, hang in there.  It can absolutely be a very bumpy and unnerving ride!  It is worth it to learn what needs to be done and to take on the challenges, with the support of your Diabetes Care and Education Specialist(s) and Diabetes Healthcare Team!  Maybe tonight we can all have a little more shuteye and improved Time in Range.

Article References: 

  1. Tavia’s FitBit sleep records for the past 2 weeks. Average time asleep decreased by 1 hour per night recently on average.  Tavia’s FitBit is in no way a reflection of actual sleep time since she perpetually forgets to charge it, or, forgets to take it off of the charger to wear it when she goes to sleep.
  2. Integrated Diabetes Services, March Madness Diabracketology, 2022 
  3. DiaTribe:  42 Factors that Affect Blood Glucose
  4. What is a Derecho? , Wikipedia – Derecho
  5. Just kidding.  I have not yet made a pump settings flip book.  Maybe in the future. Maybe I’ll have my boys do this.  They like making videos and coding. ?
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