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From Cincinnati, Ohio, USA:

In the past week or so my daughter has had more frequent lows in the afternoon, after school. I have reduced her A.M. NPH some and also increased her afternoon snack just a little. She is still having a few lows. Here's my question: for a growth spurt, are we more likely to see a period of low blood sugars or high blood sugars?


Usually during a growth spurt the insulin requirements increase (the blood sugars increase until extra insulin is given).

Two possibilities to consider:

  1. I don't know what the weather is like in Cincinnati this week, but if there has been a significant increase in temperature, many children will have low blood sugars even if they aren't more active.

  2. If your daughter is going through a growth spurt, you may have recently increased insulins other than the morning NPH which is supposed to "peak" in the afternoon. The larger the dose, the longer the insulin lasts. If you recently increased the A.M. Regular this may be continuing to work in the afternoon and causing her afternoon lows.


Original posting 13 Apr 97


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